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NPI Code Detail

MEDICARE: SSC ASHLAND OPERATING COMPANY LLC

MEDICARE: SSC ASHLAND OPERATING COMPANY LLC
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
1314000000XSkilled Nursing Facility3204WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1245351667
Entity Type Code : Organization
Provider Name (Legal Business Name) : SSC ASHLAND OPERATING COMPANY LLC
Provider Business Mailing Address
First Line : 5300 W SAM HOUSTON PKWY N
Second Line : SUITE 100
City : HOUSTON
State : TX
Zip : 77041-5161
Country : US
Telephone Number : 832-467-6000
Fax Number :
Provider Business Practice Location Address
First Line : 1319 BEASER AVE
Second Line :
City : ASHLAND
State : WI
Zip : 54806-3614
Country : US
Telephone Number : 715-682-3468
Fax Number :
Authorized Official
Title or Position : SENIOR VP OPERATIONS FINANCE
Name : THOMAS P. SIMONS
Credential :
Telephone Number : 770-829-5100
Provider Enumeration Date : 04/03/2007
Last Update Date : 07/31/2013

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Directions to “SSC ASHLAND OPERATING COMPANY LLC ” Practice Location

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