Provider Demographics
NPI:1740386473
Name:SHAIRE NURSING CENTER
Entity Type:Organization
Organization Name:SHAIRE NURSING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHEAL
Authorized Official - Middle Name:JASON
Authorized Official - Last Name:HAIRE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-728-6500
Mailing Address - Street 1:PO BOX 668
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:NC
Mailing Address - Zip Code:28638-0668
Mailing Address - Country:US
Mailing Address - Phone:828-728-6500
Mailing Address - Fax:828-728-0878
Practice Address - Street 1:1450 SHAIRE CENTER DR
Practice Address - Street 2:
Practice Address - City:LENOIR
Practice Address - State:NC
Practice Address - Zip Code:28645-7565
Practice Address - Country:US
Practice Address - Phone:828-728-6500
Practice Address - Fax:828-728-0878
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCNH0578314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0085JOtherBLUE CROSS BLUE SHIELD NC
NC340611TMedicaid
NC3405483Medicaid
NC340611TMedicaid