MEDICARE: COUNTY OF NORTHAMPTON

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	072802	PA

Other Identifiers

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

General Provider Information

NPI Number	:	1588668214
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COUNTY OF NORTHAMPTON

Provider Business Mailing Address
First Line	:	2 GRACEDALE AVE
Second Line	:
City	:	NAZARETH
State	:	PA
Zip	:	18064-8785
Country	:	US
Telephone Number	:	610-829-3818
Fax Number	:

Provider Business Practice Location Address
First Line	:	GRACEDALE AVE
Second Line	:
City	:	NAZARETH
State	:	PA
Zip	:	18064-9213
Country	:	US
Telephone Number	:	610-746-1900
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MS. JENNIFER STEWART
Credential	:	NHA
Telephone Number	:	610-746-1900

Provider Enumeration Date	:	06/10/2005
Last Update Date	:	11/08/2024

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Directions to “COUNTY OF NORTHAMPTON ” Practice Location

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