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General NPI Number Information
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NPI Number | 1376690461
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Entity Type | Organization
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Legal Business Name | SHELBY COUNTY OHIO
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Dates
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Enumeration Date | 01/04/2007
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Last Update Date | 04/19/2012
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Provider Practice Location Address
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Address Line | 2901 FAIR RD
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City | SIDNEY
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State | OH
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Zip | 45365-9534
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Country | US
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Telephone | 937-492-6900
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Fax |
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Provider Business Mailing Address
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Address Line | 2901 FAIR RD
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City | SIDNEY
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State | OH
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Zip | 45365-9534
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Country | US
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Telephone | 937-492-6900
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | ANITA S. MILLER
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Credential | LNHA
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Telephone | 937-492-6900
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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 | OH
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