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Provider Information for 1972649408


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OBERRY NEURO-MEDICAL TREATMENT CENTER

Organization Subpart: NO

NPI: 1972649408
Last Updated: 2024-10-17
Certification Date: 2024-10-17

Details

NameValue
NPI1972649408
Enumeration Date2007-01-30
NPI TypeNPI-2 Organization
StatusActive
Authorized Official Information Name: KAREN BURKES
Title: Division Director
Phone: 9198554700
Mailing Address 400 OLD SMITHFIELD ROAD
GOLDSBORO, NC 27530-8464
United States

Phone: 919-581-4000 | Fax:919-581-4038
 
Primary Practice Address 400 OLD SMITHFIELD ROAD
GOLDSBORO, NC 27530-8464
United States

Phone: 919-581-4000 | Fax:919-581-4038
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Other (non-Medicare)02815NC Board of Pharmacy
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
Yes 3336L0003X - Pharmacy - Long Term Care Pharmacy