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General NPI Number Information
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NPI Number | 1083777577
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Entity Type | Organization
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Legal Business Name | SHCP MEDINA INC.
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Dates
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Enumeration Date | 12/18/2006
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Last Update Date | 02/09/2015
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Provider Practice Location Address
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Address Line | 550 MINER DR
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City | MEDINA
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State | OH
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Zip | 44256-1472
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Country | US
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Telephone | 330-725-1550
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Fax | 330-725-8322
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Provider Business Mailing Address
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Address Line | 5625 EMERALD RIDGE PKWY
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City | SOLON
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State | OH
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Zip | 44139-1860
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Country | US
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Telephone | 440-498-3000
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Fax | 440-498-8257
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Authorized Official
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Title or Position | ATTORNEY
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Name | HAYLEY B. WILLIAMS
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Credential |
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Telephone | 216-706-3936
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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 | 1740N
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License Number State | OH
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