Healthcare Provider Details

I. General information

NPI: 1366433856
Provider Name (Legal Business Name): WEAKLEY COUNTY NURSING HOME
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 WC NURSING HOME RD
DRESDEN TN
38225-1818
US

IV. Provider business mailing address

700 WC NURSING HOME RD
DRESDEN TN
38225-1818
US

V. Phone/Fax

Practice location:
  • Phone: 731-364-3158
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License Number282
License Number StateTN

VIII. Authorized Official

Name: DAVID MCBRIDE
Title or Position: ADMINISTRATOR
Credential:
Phone: 731-364-3158