Provider Demographics
NPI:1104950765
Name:DGS HEALTHCARE ELKIN INC DBA CHATHAM NURSING AND REHABILITATION
Entity type:Organization
Organization Name:DGS HEALTHCARE ELKIN INC DBA CHATHAM NURSING AND REHABILITATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:E
Authorized Official - Last Name:GILLIAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-527-7312
Mailing Address - Street 1:700 JOHNSON RODGE ROAD
Mailing Address - Street 2:
Mailing Address - City:ELKIN
Mailing Address - State:NC
Mailing Address - Zip Code:28621
Mailing Address - Country:US
Mailing Address - Phone:336-527-7600
Mailing Address - Fax:336-527-7666
Practice Address - Street 1:700 JOHNSON RIDGE ROAD
Practice Address - Street 2:
Practice Address - City:ELKIN
Practice Address - State:NC
Practice Address - Zip Code:28621
Practice Address - Country:US
Practice Address - Phone:336-527-7600
Practice Address - Fax:336-527-7666
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-15
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCH0049314000000X
NCNH0640314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3405095Medicaid
NC00862OtherBLUE CROSS SNF
NC560642846OtherCOMMERCIAL
NC00862OtherBCBS PARTNERS/BCBS
NC805821OtherPARTNERS HEALTH SNF
NC805821OtherBCBS PARTNERS/BCBS
NC00862OtherBLUE CROSS SNF