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NPI Code Detail

MEDICARE: SHENANDOAH HEIGHTS HEALTHCARE LLC

MEDICARE: SHENANDOAH HEIGHTS HEALTHCARE 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 Facility

General Provider Information

NPI Number : 1902404569
Entity Type Code : Organization
Provider Name (Legal Business Name) : SHENANDOAH HEIGHTS HEALTHCARE LLC
Provider Business Mailing Address
First Line : 67 WALNUT RD
Second Line :
City : INWOOD
State : NY
Zip : 11096-1117
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 200 PENNSYLVANIA AVE
Second Line :
City : SHENANDOAH
State : PA
Zip : 17976-1332
Country : US
Telephone Number : 570-462-1921
Fax Number :
Authorized Official
Title or Position : MANAGER
Name : KALMAN YURMAN
Credential :
Telephone Number : 917-885-5152
Provider Enumeration Date : 10/15/2020
Last Update Date : 10/15/2020

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