Healthcare Provider Details

I. General information

NPI: 1649270521
Provider Name (Legal Business Name): METROPOLIS HEALTH CARE CENTER,LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2005
Last Update Date: 04/23/2021
Certification Date: 04/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2299 METROPOLIS ST
METROPOLIS IL
62960-1320
US

IV. Provider business mailing address

2299 METROPOLIS ST
METROPOLIS IL
62960-1320
US

V. Phone/Fax

Practice location:
  • Phone: 618-524-2634
  • Fax: 618-524-2507
Mailing address:
  • Phone: 618-524-2634
  • Fax: 618-524-2507

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number0046276
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number0046276
License Number StateIL

VIII. Authorized Official

Name: JOSEPH C TUTERA
Title or Position: PRESIDENT, CEO
Credential:
Phone: 816-444-0900