Healthcare Provider Details

I. General information

NPI: 1811007370
Provider Name (Legal Business Name): BEDFORD COUNTY NURSING HOME
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

835 UNION ST
SHELBYVILLE TN
37160-2607
US

IV. Provider business mailing address

835 UNION ST
SHELBYVILLE TN
37160-2607
US

V. Phone/Fax

Practice location:
  • Phone: 931-680-2300
  • Fax: 931-680-2273
Mailing address:
  • Phone: 931-680-2300
  • Fax: 931-680-2273

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number0000000006
License Number StateTN

VIII. Authorized Official

Name: MR. WAYNE SCHUMANN
Title or Position: ADMINISTRATOR
Credential:
Phone: 931-680-2300