Healthcare Provider Details

I. General information

NPI: 1437149986
Provider Name (Legal Business Name): MUNDAY NURSING CENTER, L.P.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2005
Last Update Date: 09/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

421 W 'F' STREET
MUNDAY TX
76371-0199
US

IV. Provider business mailing address

200 DRYDEN ROAD SUITE 2000
DRESHER PA
19025
US

V. Phone/Fax

Practice location:
  • Phone: 940-422-4541
  • Fax: 940-422-5244
Mailing address:
  • Phone: 215-441-7700
  • Fax: 215-441-4255

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BN1400X
TaxonomyNursing Facility Supplies (DME)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number115111
License Number StateTX

VIII. Authorized Official

Name: MR. PETER J LICARI
Title or Position: PRESIDENT OF GENERAL PARTNER
Credential:
Phone: 215-441-7700