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General NPI Number Information
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NPI Number | 1487132890
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Entity Type | Organization
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Legal Business Name | WINCHESTER NURSING CENTER, INC
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Dates
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Enumeration Date | 07/30/2018
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Last Update Date | 12/27/2022
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Provider Practice Location Address
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Address Line | 400 WINCHESTER ROAD
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City | BERNIE
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State | MO
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Zip | 63822-0760
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Country | US
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Telephone | 573-293-6705
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 760
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City | BERNIE
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State | MO
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Zip | 63822-0760
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Country | US
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Telephone | 573-293-6705
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Fax | 573-293-6710
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Authorized Official
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Title or Position | OWNER
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Name | MR. BENJAMIN PACK SELLS
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Credential |
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Telephone | 573-614-7472
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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 |
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