Provider Demographics
NPI:1205096781
Name:KINDRED HEALTHCARE
Entity type:Organization
Organization Name:KINDRED HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REHAB MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITEHURST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-534-4521
Mailing Address - Street 1:200 HAMPTON WOODS COMPLEX
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:NC
Mailing Address - Zip Code:27845-9503
Mailing Address - Country:US
Mailing Address - Phone:252-534-4521
Mailing Address - Fax:
Practice Address - Street 1:200 HAMPTON WOODS COMPLEX
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:NC
Practice Address - Zip Code:27845-9503
Practice Address - Country:US
Practice Address - Phone:252-534-4521
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-10
Last Update Date:2008-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility