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General NPI Number Information
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NPI Number | 1427085984
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Entity Type | Organization
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Legal Business Name | HEARTLAND OF BECKLEY WV LLC
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Dates
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Enumeration Date | 06/28/2006
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Last Update Date | 01/31/2008
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Provider Practice Location Address
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Address Line | 100 HEARTLAND DR
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City | BECKLEY
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State | WV
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Zip | 25801-2655
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Country | US
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Telephone | 304-256-1650
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Fax | 304-256-1657
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Provider Business Mailing Address
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Address Line | 333 N SUMMIT ST ATTN: BARRY LAZARUS
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City | TOLEDO
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State | OH
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Zip | 43604-1531
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Country | US
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Telephone | 419-252-5541
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Fax | 419-252-5548
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Authorized Official
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Title or Position | VICE PRESIDENT - REIMBURSEMENTS
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Name | MR. BARRY A LAZARUS
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Credential |
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Telephone | 419-252-5541
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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 | 61
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License Number State | WV
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