Provider Demographics
NPI:1629047279
Name:UNIVERSAL HEALTH CARE / KING, INC
Entity Type:Organization
Organization Name:UNIVERSAL HEALTH CARE / KING, INC
Other - Org Name:UNIVERSAL HEALTH CARE / KING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP
Authorized Official - Prefix:
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BEAVER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-459-2977
Mailing Address - Street 1:115 WHITE RD
Mailing Address - Street 2:
Mailing Address - City:KING
Mailing Address - State:NC
Mailing Address - Zip Code:27021-9526
Mailing Address - Country:US
Mailing Address - Phone:336-983-6505
Mailing Address - Fax:336-985-5340
Practice Address - Street 1:115 WHITE RD
Practice Address - Street 2:
Practice Address - City:KING
Practice Address - State:NC
Practice Address - Zip Code:27021-9526
Practice Address - Country:US
Practice Address - Phone:336-983-6505
Practice Address - Fax:336-985-5340
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-16
Last Update Date:2022-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCNH0555314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC009C1OtherBCBS PROVIDER NUMBER
NC342606JMedicaid
NC7100155OtherEVERCARE PROVIDER NUMBER
NC7804673Medicaid
NC3425449Medicaid
NC3425449Medicaid