Provider Demographics
NPI:1518952118
Name:THE REHABILITATION AND SKILLED NURSING FACILITY AT OAK SUMMIT
Entity Type:Organization
Organization Name:THE REHABILITATION AND SKILLED NURSING FACILITY AT OAK SUMMIT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:H
Authorized Official - Last Name:CHANDLER
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:336-776-5057
Mailing Address - Street 1:5680 WINDY HILL DR
Mailing Address - Street 2:
Mailing Address - City:WINSTON-SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27105-1425
Mailing Address - Country:US
Mailing Address - Phone:336-744-1188
Mailing Address - Fax:
Practice Address - Street 1:5680 WINDY HILL DR
Practice Address - Street 2:
Practice Address - City:WINSTON-SALEM
Practice Address - State:NC
Practice Address - Zip Code:27105-1425
Practice Address - Country:US
Practice Address - Phone:336-744-1188
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-20
Last Update Date:2008-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCNH0548313M00000X, 314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3405443Medicare ID - Type UnspecifiedPROVIDER #
NC345443Medicare Oscar/Certification