MEDICARE: CHESTER VALLEY SNF 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
1	332BN1400X	Nursing Facility Supplies (DME)
2	314000000X	Skilled Nursing Facility

General Provider Information

NPI Number	:	1548588668
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHESTER VALLEY SNF LLC

Provider Business Mailing Address
First Line	:	4597 ROUTE 9 N
Second Line	:
City	:	HOWELL
State	:	NJ
Zip	:	07731-3382
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	283 LANCASTER AVE
Second Line	:
City	:	MALVERN
State	:	PA
Zip	:	19355-3089
Country	:	US
Telephone Number	:	610-296-4170
Fax Number	:

Authorized Official
Title or Position	:	AUTHORIZED MEMBER
Name	:	NATHAN STERN
Credential	:
Telephone Number	:	732-942-1344

Provider Enumeration Date	:	05/13/2010
Last Update Date	:	05/13/2010

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Directions to “CHESTER VALLEY SNF LLC ” Practice Location

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