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General NPI Number Information
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NPI Number | 1790782217
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Entity Type | Organization
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Legal Business Name | BIRCHWOOD NURSING & REHAB CTR
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Dates
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Enumeration Date | 06/30/2005
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Last Update Date | 01/30/2008
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Provider Practice Location Address
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Address Line | 395 E MIDDLE RD
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City | NANTICOKE
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State | PA
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Zip | 18634-3806
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Country | US
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Telephone | 570-735-2973
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Fax | 570-735-8420
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Provider Business Mailing Address
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Address Line | 395 E MIDDLE ROAD
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City | NANTICOKE
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State | PA
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Zip | 18634-3806
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Country | US
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Telephone | 570-735-2973
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Fax | 570-735-8420
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Authorized Official
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Title or Position | C.F.O.
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Name | SAM KRAVETZ
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Credential |
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Telephone | 732-942-1344
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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 | 026402
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License Number State | PA
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