Provider Demographics
NPI:1457388670
Name:WNC LONG TERM CARE INC
Entity Type:Organization
Organization Name:WNC LONG TERM CARE INC
Other - Org Name:DAVID L. FARLEY, MD
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:FARLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:828-369-6144
Mailing Address - Street 1:1385 RAY COVE ROAD
Mailing Address - Street 2:WNC LONG TERM CARE INC
Mailing Address - City:FRANKLIN
Mailing Address - State:NC
Mailing Address - Zip Code:28734
Mailing Address - Country:US
Mailing Address - Phone:828-369-6144
Mailing Address - Fax:866-253-8199
Practice Address - Street 1:3195 OLD MURPHY RD
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:NC
Practice Address - Zip Code:28734
Practice Address - Country:US
Practice Address - Phone:828-369-6144
Practice Address - Fax:866-253-8199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-26
Last Update Date:2014-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC29834207R00000X, 207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Single Specialty
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0272AOtherBCBSNC
NC890272AMedicaid
NC890272AMedicaid
NC203667EMedicare PIN