MEDICARE: DEAMC

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	4585	OH

General Provider Information

NPI Number	:	1356403190
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DEAMC

Provider Business Mailing Address
First Line	:	5176 WASHINGTON RD
Second Line	:
City	:	ALBANY
State	:	OH
Zip	:	45710-9400
Country	:	US
Telephone Number	:	740-698-3631
Fax Number	:	740-698-4703

Provider Business Practice Location Address
First Line	:	5176 WASHINGTON RD
Second Line	:
City	:	ALBANY
State	:	OH
Zip	:	45710-9400
Country	:	US
Telephone Number	:	740-698-3631
Fax Number	:	740-698-4703

Authorized Official
Title or Position	:	ADMIISTRATOR
Name	:	MR. JEFFREY A MCDANIEL
Credential	:	NHA.
Telephone Number	:	740-698-3931

Provider Enumeration Date	:	12/15/2006
Last Update Date	:	08/22/2020

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Directions to “DEAMC ” Practice Location

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