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NPI Code Detail

MEDICARE: GMA-MADISON INC

MEDICARE: GMA-MADISON INC
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 Facility131WV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12507253OTHERAETNA-HMO
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3NZ5OTHERCAREFIRST BLUECHOICE
4000324442OTHERMOUNTAIN STATE
502EFOTHERCAREFIRST - PROV/INQ#
6NZ5OTHERCAREFIRST IND/PPO
7282334OTHERUNITED - MAMSI

General Provider Information

NPI Number : 1730120486
Entity Type Code : Organization
Provider Name (Legal Business Name) : GMA-MADISON INC
Provider Business Mailing Address
First Line : 101 E STATE ST
Second Line :
City : KENNETT SQUARE
State : PA
Zip : 19348-3109
Country : US
Telephone Number : 610-925-4436
Fax Number : 610-925-4351
Provider Business Practice Location Address
First Line : 161 BAKERS RIDGE RD
Second Line :
City : MORGANTOWN
State : WV
Zip : 26508-1459
Country : US
Telephone Number : 304-285-0692
Fax Number : 304-285-0693
Authorized Official
Title or Position : CORPORATE MANAGER
Name : JANE DROPESKEY
Credential :
Telephone Number : 610-925-4231
Provider Enumeration Date : 06/10/2006
Last Update Date : 06/21/2018

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