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NPI Code Detail

MEDICARE: THE WATERS OF STAMPS, LLC

MEDICARE: THE WATERS OF STAMPS, 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

General Provider Information

NPI Number : 1427532845
Entity Type Code : Organization
Provider Name (Legal Business Name) : THE WATERS OF STAMPS, LLC
Provider Business Mailing Address
First Line : 826 NORTH ST
Second Line :
City : STAMPS
State : AR
Zip : 71860-4522
Country : US
Telephone Number : 870-533-4444
Fax Number :
Provider Business Practice Location Address
First Line : 826 NORTH ST
Second Line :
City : STAMPS
State : AR
Zip : 71860-4522
Country : US
Telephone Number : 870-533-4444
Fax Number :
Authorized Official
Title or Position : MBR
Name : MICHAEL BLISKO
Credential :
Telephone Number : 708-449-1900
Provider Enumeration Date : 09/21/2018
Last Update Date : 09/21/2018

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Directions to “THE WATERS OF STAMPS, LLC ” Practice Location

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