Healthcare Provider Details

I. General information

NPI: 1477588481
Provider Name (Legal Business Name): SCOTT COUNTY NURSING CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/11/2006
Last Update Date: 04/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

650 N MAIN ST
WINCHESTER IL
62694-3611
US

IV. Provider business mailing address

650 N MAIN ST
WINCHESTER IL
62694-3611
US

V. Phone/Fax

Practice location:
  • Phone: 217-742-3101
  • Fax: 217-742-8063
Mailing address:
  • Phone: 217-742-3101
  • Fax: 217-742-8063

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: MS. JULIE J LAWSON
Title or Position: MEDICARE COORDINATOR
Credential: LPN
Phone: 217-742-3101