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General NPI Number Information
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NPI Number | 1467110593
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Entity Type | Organization
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Legal Business Name | MEADOW BROOK SKILLED NURSING AND REHAB LLC
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Dates
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Enumeration Date | 12/06/2021
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Last Update Date | 12/06/2021
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Provider Practice Location Address
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Address Line | 320 S 2ND ST
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City | GRAYVILLE
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State | IL
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Zip | 62844-1527
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Country | US
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Telephone | 618-375-2171
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Fax |
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Provider Business Mailing Address
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Address Line | 575 ROUTE 70
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City | BRICK
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State | NJ
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Zip | 08723-4042
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | MEIR SINGER
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Credential |
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Telephone | 618-375-2171
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number |
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License Number State |
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