MEDICARE: JUDSON CARE CENTER

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

General Provider Information

NPI Number	:	1821484247
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JUDSON CARE CENTER

Provider Business Mailing Address
First Line	:	3225 OAKLEY STATION BLVD
Second Line	:	APT 120
City	:	CINCINNATI
State	:	OH
Zip	:	45209-1276
Country	:	US
Telephone Number	:	724-466-9145
Fax Number	:

Provider Business Practice Location Address
First Line	:	3225 OAKLEY STATION BLVD
Second Line	:	APT 120
City	:	CINCINNATI
State	:	OH
Zip	:	45209-1276
Country	:	US
Telephone Number	:	724-466-9145
Fax Number	:

Authorized Official
Title or Position	:	SLP
Name	:	MARY COCH
Credential	:	CFY
Telephone Number	:	724-466-9145

Provider Enumeration Date	:	04/13/2015
Last Update Date	:	04/13/2015

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Directions to “JUDSON CARE CENTER ” Practice Location

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