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NPI Code Detail

MEDICARE: MEADOW GREEN NURSING HOME, INC.

MEDICARE: MEADOW GREEN NURSING HOME, 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 Facility0889MA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1780670869
Entity Type Code : Organization
Provider Name (Legal Business Name) : MEADOW GREEN NURSING HOME, INC.
Provider Business Mailing Address
First Line : 45 WOBURN ST
Second Line :
City : WALTHAM
State : MA
Zip : 02452-7919
Country : US
Telephone Number : 781-899-8600
Fax Number : 781-899-3124
Provider Business Practice Location Address
First Line : 45 WOBURN ST
Second Line :
City : WALTHAM
State : MA
Zip : 02452-7919
Country : US
Telephone Number : 781-899-8600
Fax Number : 781-899-3124
Authorized Official
Title or Position : DIRECTOR OF OPERATIONS
Name : MR. NORMAN J SCZEPANSKI JR.
Credential :
Telephone Number : 781-237-8503
Provider Enumeration Date : 09/23/2005
Last Update Date : 04/08/2015

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Directions to “MEADOW GREEN NURSING HOME, INC. ” Practice Location

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