Healthcare Provider Details

I. General information

NPI: 1134119555
Provider Name (Legal Business Name): WORTHINGTON NURSING & REHABILITATION CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2005
Last Update Date: 12/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2675 36TH ST
PARKERSBURG WV
26104-8024
US

IV. Provider business mailing address

2675 36TH ST
PARKERSBURG WV
26104-8024
US

V. Phone/Fax

Practice location:
  • Phone: 304-485-7447
  • Fax: 304-485-9344
Mailing address:
  • Phone: 304-448-5744
  • Fax: 304-485-9344

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number56
License Number StateWV

VIII. Authorized Official

Name: MR. MOSHE ORLINSKY
Title or Position: MANAGING MEMBER
Credential:
Phone: 314-588-7518