Provider Demographics
NPI:1922032820
Name:GALLOWAY RIDGE, INC.
Entity Type:Organization
Organization Name:GALLOWAY RIDGE, INC.
Other - Org Name:THE DUKE CENTER FOR LIVEING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:P
Authorized Official - Last Name:ZIMMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-545-2604
Mailing Address - Street 1:3000 GALLOWAY RIDGE ROAD
Mailing Address - Street 2:
Mailing Address - City:PITTSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27312-8639
Mailing Address - Country:US
Mailing Address - Phone:919-545-2215
Mailing Address - Fax:919-545-2696
Practice Address - Street 1:300 CLYNELISH CLOSE
Practice Address - Street 2:
Practice Address - City:PITTSBORO
Practice Address - State:NC
Practice Address - Zip Code:27312
Practice Address - Country:US
Practice Address - Phone:919-545-2660
Practice Address - Fax:919-545-2696
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-10
Last Update Date:2022-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC345539Medicare PIN