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General NPI Number Information
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NPI Number | 1316947401
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Entity Type | Organization
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Legal Business Name | PCC INVESTMENTS, INC.
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Dates
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Enumeration Date | 07/29/2005
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Last Update Date | 06/03/2009
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Provider Practice Location Address
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Address Line | 105 S 6TH ST
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City | PACIFIC
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State | MO
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Zip | 63069-1328
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Country | US
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Telephone | 636-271-4222
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Fax | 636-257-8002
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Provider Business Mailing Address
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Address Line | 105 S 6TH ST
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City | PACIFIC
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State | MO
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Zip | 63069-1328
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Country | US
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Telephone | 636-271-4222
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Fax | 636-257-8002
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | GRETCHEN GULLET
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Credential |
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Telephone | 636-271-4222
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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 | 031421
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License Number State | MO
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