Provider Demographics
NPI:1225019359
Name:THE CEDARS OF CHAPEL HILL CLUB, INC
Entity Type:Organization
Organization Name:THE CEDARS OF CHAPEL HILL CLUB, INC
Other - Org Name:THE CEDARS OF CHAPEL HILL
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:E
Authorized Official - Last Name:WOODRUFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-259-7000
Mailing Address - Street 1:100 CEDAR CLUB CIR
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27517-7809
Mailing Address - Country:US
Mailing Address - Phone:919-259-7000
Mailing Address - Fax:919-259-7001
Practice Address - Street 1:101 GREEN CEDAR LN
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27517
Practice Address - Country:US
Practice Address - Phone:919-259-7903
Practice Address - Fax:919-259-7943
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-07
Last Update Date:2018-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCNH0615314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC345533Medicare Oscar/Certification