Healthcare Provider Details

I. General information

NPI: 1164652327
Provider Name (Legal Business Name): MIDWEST CARE GROVE CITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2009
Last Update Date: 07/22/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2320 SONORA DR
GROVE CITY OH
43123-2423
US

IV. Provider business mailing address

2 WISCONSIN CIR SUITE 540
CHEVY CHASE MD
20815-7003
US

V. Phone/Fax

Practice location:
  • Phone: 614-871-8000
  • Fax: 614-871-8801
Mailing address:
  • Phone: 301-941-1660
  • Fax: 301-941-1661

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. SEAN P. MURPHY
Title or Position: PRESIDENT
Credential:
Phone: 301-941-1690