MEDICARE: MURFREESBORO REHAB AND NURSING 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
1	314000000X	Skilled Nursing Facility

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	045415	OTHER	AR	MEDICARE ID#

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	:	1821302431
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MURFREESBORO REHAB AND NURSING INC.

Provider Business Mailing Address
First Line	:	110 W 13TH ST
Second Line	:
City	:	MURFREESBORO
State	:	AR
Zip	:	71958-9501
Country	:	US
Telephone Number	:	870-285-2186
Fax Number	:	870-285-2348

Provider Business Practice Location Address
First Line	:	110 W 13TH ST
Second Line	:
City	:	MURFREESBORO
State	:	AR
Zip	:	71958-9501
Country	:	US
Telephone Number	:	870-285-2186
Fax Number	:	870-285-2348

Authorized Official
Title or Position	:	OWNER/ADMINISTRATOR
Name	:	MS. SANDRA L TIDWELL
Credential	:
Telephone Number	:	870-285-2186

Provider Enumeration Date	:	08/06/2010
Last Update Date	:	08/06/2010

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