MEDICARE: INFINIA AT SMITH CENTER

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	N-092-001	KS

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	:	1598762189
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INFINIA AT SMITH CENTER

Provider Business Mailing Address
First Line	:	PO BOX 369
Second Line	:
City	:	SMITH CENTER
State	:	KS
Zip	:	66967-0369
Country	:	US
Telephone Number	:	785-282-6696
Fax Number	:	785-282-3895

Provider Business Practice Location Address
First Line	:	117 W 1ST ST
Second Line	:
City	:	SMITH CENTER
State	:	KS
Zip	:	66967-2005
Country	:	US
Telephone Number	:	785-282-6696
Fax Number	:	785-282-3895

Authorized Official
Title or Position	:	OWNER
Name	:	JON ROBERTSON
Credential	:
Telephone Number	:	801-296-5105

Provider Enumeration Date	:	06/28/2005
Last Update Date	:	06/12/2008

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Directions to “INFINIA AT SMITH CENTER ” Practice Location

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