Provider Demographics
NPI:1326111287
Name:EASTCO MANGEMENT CORP.
Entity Type:Organization
Organization Name:EASTCO MANGEMENT CORP.
Other - Org Name:THE MEADOWS OF ROCKWELL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LOUSIE
Authorized Official - Middle Name:
Authorized Official - Last Name:KETNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-279-5300
Mailing Address - Street 1:612 HIGHWAY 152 E
Mailing Address - Street 2:
Mailing Address - City:ROCKWELL
Mailing Address - State:NC
Mailing Address - Zip Code:28138-9466
Mailing Address - Country:US
Mailing Address - Phone:704-279-5300
Mailing Address - Fax:704-279-1702
Practice Address - Street 1:612 HIGHWAY 152 E
Practice Address - Street 2:
Practice Address - City:ROCKWELL
Practice Address - State:NC
Practice Address - Zip Code:28138-9466
Practice Address - Country:US
Practice Address - Phone:704-279-5300
Practice Address - Fax:704-279-1702
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7801083Medicaid