Healthcare Provider Details

I. General information

NPI: 1548588668
Provider Name (Legal Business Name): CHESTER VALLEY SNF LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2010
Last Update Date: 05/13/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

283 LANCASTER AVE
MALVERN PA
19355-3089
US

IV. Provider business mailing address

4597 ROUTE 9 N
HOWELL NJ
07731-3382
US

V. Phone/Fax

Practice location:
  • Phone: 610-296-4170
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BN1400X
TaxonomyNursing Facility Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: NATHAN STERN
Title or Position: AUTHORIZED MEMBER
Credential:
Phone: 732-942-1344