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NPI Code Detail

MEDICARE: GUARDIAN ELDER CARE AT ERIE II LLC

MEDICARE: GUARDIAN ELDER CARE AT ERIE II 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 Facility

Other Identifiers

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

General Provider Information

NPI Number : 1275086050
Entity Type Code : Organization
Provider Name (Legal Business Name) : GUARDIAN ELDER CARE AT ERIE II LLC
Provider Business Mailing Address
First Line : 8796 ROUTE 219
Second Line :
City : BROCKWAY
State : PA
Zip : 15824-6010
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4850 ZUCK RD
Second Line :
City : ERIE
State : PA
Zip : 16506-4936
Country : US
Telephone Number : 814-836-3300
Fax Number :
Authorized Official
Title or Position : CFO
Name : ARMANDO FORTUNATO
Credential :
Telephone Number : 814-265-1164
Provider Enumeration Date : 07/28/2016
Last Update Date : 05/18/2023

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Directions to “GUARDIAN ELDER CARE AT ERIE II LLC ” Practice Location

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