Healthcare Provider Details

I. General information

NPI: 1093346975
Provider Name (Legal Business Name): AMERICAN NURSING & REHAB LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2020
Last Update Date: 01/30/2020
Certification Date: 01/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 LAKE DRIVE
BONNE TERRE MO
63628-1820
US

IV. Provider business mailing address

2732 BLOOMFIELD RD
CAPE GIRARDEAU MO
63703-6302
US

V. Phone/Fax

Practice location:
  • Phone: 573-358-2800
  • Fax:
Mailing address:
  • Phone: 573-335-3044
  • Fax: 573-335-6724

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: MR. SHAFIQ MALIK
Title or Position: PRESIDENT
Credential:
Phone: 573-335-3044