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NPI Code Detail

MEDICARE: MCGREGOR SENIOR CARE, LLC

MEDICARE: MCGREGOR SENIOR CARE, 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 FacilityTX

General Provider Information

NPI Number : 1972046068
Entity Type Code : Organization
Provider Name (Legal Business Name) : MCGREGOR SENIOR CARE, LLC
Provider Business Mailing Address
First Line : 6500 HORIZON CIRCLE
Second Line :
City : WACO
State : TX
Zip : 76712
Country : US
Telephone Number : 254-741-5929
Fax Number : 254-741-5928
Provider Business Practice Location Address
First Line : 901 PENNSYLVANIA AVE
Second Line :
City : FORT WORTH
State : TX
Zip : 76104-2226
Country : US
Telephone Number : 254-741-5929
Fax Number : 254-741-5928
Authorized Official
Title or Position : MEMBER
Name : JACK COOK
Credential :
Telephone Number : 254-741-5929
Provider Enumeration Date : 11/22/2016
Last Update Date : 11/22/2016

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Directions to “MCGREGOR SENIOR CARE, LLC ” Practice Location

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