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NPI Code Detail

MEDICARE: SAINT IGNATIUS NURSING HOME

MEDICARE: SAINT IGNATIUS NURSING HOME
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 Facility450602PA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10649930001OTHERPANSC
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1336179043
Entity Type Code : Organization
Provider Name (Legal Business Name) : SAINT IGNATIUS NURSING HOME
Provider Business Mailing Address
First Line : 4401 HAVERFORD AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19104-1332
Country : US
Telephone Number : 215-349-8800
Fax Number : 215-222-3078
Provider Business Practice Location Address
First Line : 4401 HAVERFORD AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19104-1332
Country : US
Telephone Number : 215-349-8800
Fax Number : 215-222-3078
Authorized Official
Title or Position : ADMINISTRATOR
Name : MR. JOHN W MEACHAM
Credential :
Telephone Number : 215-349-8800
Provider Enumeration Date : 07/05/2006
Last Update Date : 03/04/2010

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Directions to “SAINT IGNATIUS NURSING HOME ” Practice Location

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