Provider Demographics
NPI:1245224617
Name:CARTERET COUNTY GENERAL HOSPITAL CORPORATION
Entity Type:Organization
Organization Name:CARTERET COUNTY GENERAL HOSPITAL CORPORATION
Other - Org Name:TAYLOR EXTENDED CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:FUCHS
Authorized Official - Last Name:YEOMANS
Authorized Official - Suffix:
Authorized Official - Credentials:NHA
Authorized Official - Phone:252-225-2415
Mailing Address - Street 1:468 HIGHWAY 70
Mailing Address - Street 2:P.O. BOX 100
Mailing Address - City:SEA LEVEL
Mailing Address - State:NC
Mailing Address - Zip Code:28577-0100
Mailing Address - Country:US
Mailing Address - Phone:252-225-4611
Mailing Address - Fax:252-225-1228
Practice Address - Street 1:468 HIGHWAY 70 EAST
Practice Address - Street 2:
Practice Address - City:SEA LEVEL
Practice Address - State:NC
Practice Address - Zip Code:28577-0100
Practice Address - Country:US
Practice Address - Phone:252-225-4611
Practice Address - Fax:252-225-1228
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-31
Last Update Date:2009-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCNH0600314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0091HOtherBLUE CROSS, STATE HEALTH
NC3425182Medicaid
NC345182Medicare PIN
NC3425182Medicaid