Provider Demographics
NPI:1063696805
Name:TAYLOR ECF
Entity type:Organization
Organization Name:TAYLOR ECF
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINSTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:
Authorized Official - Last Name:YEOMANS
Authorized Official - Suffix:
Authorized Official - Credentials:LNHA
Authorized Official - Phone:252-225-2415
Mailing Address - Street 1:PO BOX 100
Mailing Address - Street 2:
Mailing Address - City:SEALEVEL
Mailing Address - State:NC
Mailing Address - Zip Code:28577-0100
Mailing Address - Country:US
Mailing Address - Phone:252-225-4611
Mailing Address - Fax:252-225-1228
Practice Address - Street 1:468 HWY 70 EAST
Practice Address - Street 2:
Practice Address - City:SEA LEVEL
Practice Address - State:NC
Practice Address - Zip Code:28577-0100
Practice Address - Country:US
Practice Address - Phone:252-225-4611
Practice Address - Fax:252-225-1228
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-27
Last Update Date:2007-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCNH0600313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3426158Medicaid