Provider Demographics
NPI:1689736936
Name:MAYVIEW CONVALESCENT HOME, INC.
Entity Type:Organization
Organization Name:MAYVIEW CONVALESCENT HOME, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT-OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:PARKER
Authorized Official - Last Name:TOMLINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-828-2348
Mailing Address - Street 1:513 E WHITAKER MILL RD
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27608-2633
Mailing Address - Country:US
Mailing Address - Phone:919-828-2348
Mailing Address - Fax:919-828-7554
Practice Address - Street 1:513 E WHITAKER MILL RD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27608-2633
Practice Address - Country:US
Practice Address - Phone:919-828-2348
Practice Address - Fax:919-828-7554
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0130590001Medicare NSC