Provider Demographics
NPI:1215706924
Name:SCOTLAND NECK NC OPCO LLC
Entity type:Organization
Organization Name:SCOTLAND NECK NC OPCO LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ITAMAR
Authorized Official - Middle Name:BINYOMIN
Authorized Official - Last Name:COHEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-826-5146
Mailing Address - Street 1:920 JR HIGH SCHOOL RD
Mailing Address - Street 2:
Mailing Address - City:SCOTLAND NECK
Mailing Address - State:NC
Mailing Address - Zip Code:27874-1218
Mailing Address - Country:US
Mailing Address - Phone:252-826-5146
Mailing Address - Fax:
Practice Address - Street 1:920 JR HIGH SCHOOL RD
Practice Address - Street 2:
Practice Address - City:SCOTLAND NECK
Practice Address - State:NC
Practice Address - Zip Code:27874-1218
Practice Address - Country:US
Practice Address - Phone:252-826-5146
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-21
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility