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General NPI Number Information
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NPI Number | 1114932852
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Entity Type | Organization
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Legal Business Name | MARY SCOTT NURSING HOME, INC.
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Dates
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Enumeration Date | 07/30/2006
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Last Update Date | 06/16/2009
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Provider Practice Location Address
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Address Line | 3109 CAMPUS DRIVE
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City | DAYTON
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State | OH
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Zip | 45406
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Country | US
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Telephone | 937-278-0761
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Fax | 937-278-6482
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Provider Business Mailing Address
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Address Line | 3109 CAMPUS DRIVE
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City | DAYTON
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State | OH
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Zip | 45406
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Country | US
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Telephone | 937-278-0761
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Fax | 937-278-6482
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Authorized Official
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Title or Position | BUSINESS OFFICE MANAGER
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Name | MS. SUE D. DUCKER
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Credential |
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Telephone | 937-278-0761
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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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Taxonomy #2
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 4241
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License Number State | OH
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