MEDICARE: LUTHERCARE

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	314000000X	Skilled Nursing Facility	122402	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1174510325
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LUTHERCARE

Provider Business Mailing Address
First Line	:	600 EAST MAIN STREET
Second Line	:
City	:	LITITZ
State	:	PA
Zip	:	17543-2224
Country	:	US
Telephone Number	:	717-626-1171
Fax Number	:	717-626-4390

Provider Business Practice Location Address
First Line	:	400 SAINT LUKE DRIVE
Second Line	:
City	:	LITITZ
State	:	PA
Zip	:	17543-2208
Country	:	US
Telephone Number	:	717-626-6884
Fax Number	:	717-626-4390

Authorized Official
Title or Position	:	PRESIDENT CEO
Name	:	MR. CARL R MCALOOSE
Credential	:
Telephone Number	:	717-626-1171

Provider Enumeration Date	:	10/03/2005
Last Update Date	:	01/17/2012

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Directions to “LUTHERCARE ” Practice Location

Language	Start Address	Practice Location

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