MEDICARE: WINTHROP HEALTHCARE INVESTORS D B A

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	0565	MA

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	:	1669467973
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WINTHROP HEALTHCARE INVESTORS D B A

Provider Business Mailing Address
First Line	:	142 PLEASANT ST
Second Line	:
City	:	WINTHROP
State	:	MA
Zip	:	02152-2042
Country	:	US
Telephone Number	:	617-846-7750
Fax Number	:	617-846-2302

Provider Business Practice Location Address
First Line	:	142 PLEASANT ST
Second Line	:
City	:	WINTHROP
State	:	MA
Zip	:	02152-2042
Country	:	US
Telephone Number	:	617-846-7750
Fax Number	:	617-846-2302

Authorized Official
Title or Position	:	PRESIDENT SEC-TREASURER
Name	:	MR. DOU MITTLEIDER
Credential	:
Telephone Number	:	770-870-2813

Provider Enumeration Date	:	09/13/2005
Last Update Date	:	08/22/2020

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