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General NPI Number Information
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NPI Number | 1053026997
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Entity Type | Organization
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Legal Business Name | EPWORTH REHABILITATION AND HEALTHCARE LLC
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Dates
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Enumeration Date | 01/16/2023
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Last Update Date | 06/07/2023
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Provider Practice Location Address
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Address Line | 951 WASHINGTON AVE
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City | TYRONE
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State | PA
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Zip | 16686-1426
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Country | US
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Telephone | 814-684-0320
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Fax |
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Provider Business Mailing Address
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Address Line | 575 ROUTE 70 FL 2
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City | BRICK
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State | NJ
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Zip | 08723-4042
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | SHAI BERDUGO
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Credential |
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Telephone | 814-684-0320
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State |
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