Healthcare Provider Details

I. General information

NPI: 1922280239
Provider Name (Legal Business Name): 850 PAPER MILL ROAD OPERATIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/28/2007
Last Update Date: 07/19/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

850 PAPER MILL RD
GLENSIDE PA
19038-7833
US

IV. Provider business mailing address

101 E STATE ST
KENNETT SQUARE PA
19348-3109
US

V. Phone/Fax

Practice location:
  • Phone: 215-233-0920
  • Fax: 215-836-1247
Mailing address:
  • Phone: 610-925-4436
  • Fax: 610-925-4351

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number580502
License Number StatePA

VIII. Authorized Official

Name: JANE DROPESKEY
Title or Position: DATA MANAGER
Credential:
Phone: 610-925-4231