Provider Demographics
NPI:1770971020
Name:BJR, INC
Entity type:Organization
Organization Name:BJR, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROY
Authorized Official - Middle Name:EXCELL
Authorized Official - Last Name:MARKHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-778-6974
Mailing Address - Street 1:206B MALLOY ST
Mailing Address - Street 2:
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27534-4477
Mailing Address - Country:US
Mailing Address - Phone:919-778-6974
Mailing Address - Fax:919-778-6997
Practice Address - Street 1:503 W. BUNCOMBE ST
Practice Address - Street 2:
Practice Address - City:ROPER
Practice Address - State:NC
Practice Address - Zip Code:27970-0340
Practice Address - Country:US
Practice Address - Phone:252-791-0002
Practice Address - Fax:252-791-0772
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-08
Last Update Date:2015-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHAL-094-006310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility