Provider Demographics
NPI:1790754588
Name:BN HEALTHCARE, LLC
Entity Type:Organization
Organization Name:BN HEALTHCARE, LLC
Other - Org Name:HARNETT MANOR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:
Authorized Official - Last Name:PRATER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-633-0055
Mailing Address - Street 1:1995 E CORNELIUS HARNETT BLVD
Mailing Address - Street 2:
Mailing Address - City:LILLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27546-8276
Mailing Address - Country:US
Mailing Address - Phone:910-893-5141
Mailing Address - Fax:910-893-4595
Practice Address - Street 1:1995 E CORNELIUS HARNETT BLVD
Practice Address - Street 2:
Practice Address - City:LILLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27546-8276
Practice Address - Country:US
Practice Address - Phone:910-893-5141
Practice Address - Fax:910-893-4595
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCNH0444314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3425213Medicaid
NC7804650Medicaid
NC3416498Medicaid
NC0095EOtherBCBS PROVIDER NUMBER
NC3416498Medicaid