MEDICARE: DAWN VIEW MANOR, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	343900000X	Non-emergency Medical Transport (VAN)	87	WV
2	314000000X	Skilled Nursing Facility	87	WV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	2507221	OTHER	AETNA-HMO
3	000302051	OTHER	MOUNTAIN STATE BC/BS
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	0283	OTHER	CAREFIRST - PROV/INQ #
6	281347	OTHER	UNITED - MAMSI
7	PY5	OTHER	CAREFIRST - IND/PPO
8	PY5	OTHER	CAREFIRST BLUECHOICE

General Provider Information

NPI Number	:	1144269663
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DAWN VIEW MANOR, INC.

Provider Business Mailing Address
First Line	:	101 E STATE ST
Second Line	:
City	:	KENNETT SQUARE
State	:	PA
Zip	:	19348-3109
Country	:	US
Telephone Number	:	610-925-4436
Fax Number	:	610-925-4351

Provider Business Practice Location Address
First Line	:	DIANE DRIVE
Second Line	:
City	:	FORT ASHBY
State	:	WV
Zip	:	26719
Country	:	US
Telephone Number	:	304-298-3602
Fax Number	:	304-298-4597

Authorized Official
Title or Position	:	CORPORATE MANAGER
Name	:	JANE DROPESKEY
Credential	:
Telephone Number	:	610-925-4231

Provider Enumeration Date	:	06/06/2006
Last Update Date	:	06/21/2018

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Directions to “DAWN VIEW MANOR, INC. ” Practice Location

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