Healthcare Provider Details

I. General information

NPI: 1891760963
Provider Name (Legal Business Name): UVMC NURSING CARE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4375 S COUNTY ROAD 25A
TIPP CITY OH
45371-2956
US

IV. Provider business mailing address

4375 S COUNTY ROAD 25A
TIPP CITY OH
45371-2956
US

V. Phone/Fax

Practice location:
  • Phone: 937-667-7500
  • Fax: 937-667-9339
Mailing address:
  • Phone: 937-667-7500
  • Fax: 937-667-9339

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number0882880
License Number StateOH

VIII. Authorized Official

Name: MS. CAROL J GROEBER
Title or Position: VICE PRESIDENT/MIS
Credential:
Phone: 937-964-8974