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NPI Code Detail

MEDICARE: TRILOGY HEALTHCARE OF DELPHOS, LLC

MEDICARE: TRILOGY HEALTHCARE OF DELPHOS, 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 FacilityOH

General Provider Information

NPI Number : 1780195602
Entity Type Code : Organization
Provider Name (Legal Business Name) : TRILOGY HEALTHCARE OF DELPHOS, LLC
Provider Business Mailing Address
First Line : PO BOX 221648
Second Line :
City : LOUISVILLE
State : KY
Zip : 40252-1648
Country : US
Telephone Number : 502-412-5847
Fax Number :
Provider Business Practice Location Address
First Line : 800 AMBROSE DR
Second Line :
City : DELPHOS
State : OH
Zip : 45833-9146
Country : US
Telephone Number : 419-692-0590
Fax Number : 419-692-0591
Authorized Official
Title or Position : SR. VICE PRESIDENT AND TREASURER
Name : BRAD WILLIAMSON
Credential :
Telephone Number : 502-412-5847
Provider Enumeration Date : 10/18/2017
Last Update Date : 10/18/2017

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Directions to “TRILOGY HEALTHCARE OF DELPHOS, LLC ” Practice Location

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