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General NPI Number Information
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NPI Number | 1861612681
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Entity Type | Organization
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Legal Business Name | MID-SOUTH NURSING HOMES, INC
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Dates
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Enumeration Date | 04/26/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 950 HIGHPOINT DR
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City | HOPKINSVILLE
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State | KY
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Zip | 42240-2570
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Country | US
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Telephone | 270-885-1151
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Fax | 270-885-7461
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Provider Business Mailing Address
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Address Line | 602 COURTLAND ST SUITE 200
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City | ORLANDO
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State | FL
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Zip | 32804-1360
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Country | US
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Telephone | 407-975-3000
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Fax | 407-975-3090
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Authorized Official
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Title or Position | VP CFO
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Name | MR. RONALD M WEHTJE
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Credential |
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Telephone | 407-975-3010
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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 | 100070
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License Number State | KY
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