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General NPI Number Information
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NPI Number | 1245272020
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Entity Type | Organization
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Legal Business Name | GLENMARK LIMITED LIABILITY COMPANY I
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Dates
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Enumeration Date | 06/13/2006
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Last Update Date | 08/17/2018
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Provider Practice Location Address
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Address Line | 200 S RITCHIE AVE
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City | RAVENSWOOD
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State | WV
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Zip | 26164-1721
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Country | US
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Telephone | 304-273-9385
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Fax | 304-273-9387
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Provider Business Mailing Address
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Address Line | 101 E STATE ST
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City | KENNETT SQUARE
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State | PA
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Zip | 19348-3109
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Country | US
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Telephone | 610-925-4436
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Fax | 610-925-4351
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Authorized Official
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Title or Position | CORPORATE MANAGER
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Name | JANE DROPESKEY
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Credential |
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Telephone | 610-925-4231
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number | 122
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License Number State | WV
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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 | 122
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License Number State | WV
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