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NPI Code Detail

MEDICARE: NHC HEALTHCARE-MARYLAND HEIGHTS LLC

MEDICARE: NHC HEALTHCARE-MARYLAND HEIGHTS 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
1314000000XSkilled Nursing Facility031078MO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
113423OTHERMOBCBS
243754OTHERGHP
3110502OTHERMOBCBS
47100054OTHERUNITED

General Provider Information

NPI Number : 1760420368
Entity Type Code : Organization
Provider Name (Legal Business Name) : NHC HEALTHCARE-MARYLAND HEIGHTS LLC
Provider Business Mailing Address
First Line : 2920 FEE FEE RD
Second Line :
City : MARYLAND HEIGHTS
State : MO
Zip : 63043-1915
Country : US
Telephone Number : 314-291-0121
Fax Number :
Provider Business Practice Location Address
First Line : 2920 FEE FEE RD
Second Line :
City : MARYLAND HEIGHTS
State : MO
Zip : 63043-1915
Country : US
Telephone Number : 314-291-0121
Fax Number :
Authorized Official
Title or Position : SVP
Name : ROBERT MICHAEL USSERY
Credential :
Telephone Number : 615-890-2020
Provider Enumeration Date : 06/03/2006
Last Update Date : 03/19/2008

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