Provider Demographics
NPI:1801837091
Name:PARAMOUNT GROUP INC
Entity Type:Organization
Organization Name:PARAMOUNT GROUP INC
Other - Org Name:BERMUDA TERRACE NURSING & REHABILITATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT OF FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:TURNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-253-9046
Mailing Address - Street 1:316 HIGHWAY 801 SOUTH
Mailing Address - Street 2:
Mailing Address - City:ADVANCE
Mailing Address - State:NC
Mailing Address - Zip Code:27006
Mailing Address - Country:US
Mailing Address - Phone:336-998-0240
Mailing Address - Fax:
Practice Address - Street 1:316 HIGHWAY 801 SOUTH
Practice Address - Street 2:
Practice Address - City:ADVANCE
Practice Address - State:NC
Practice Address - Zip Code:27006
Practice Address - Country:US
Practice Address - Phone:336-998-0240
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC03-54-089314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC340607RMedicaid
NC345456Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER