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General NPI Number Information
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NPI Number | 1992757579
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Entity Type | Organization
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Legal Business Name | VERNON CARE CENTER, L.P.
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Dates
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Enumeration Date | 05/16/2006
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Last Update Date | 10/30/2007
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Provider Practice Location Address
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Address Line | 2301 TEXAS STREET
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City | VERNON
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State | TX
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Zip | 76384
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Country | US
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Telephone | 940-552-9316
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Fax | 940-552-5570
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Provider Business Mailing Address
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Address Line | 200 DRYDEN ROAD SUITE 2000
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City | DRESHER
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State | PA
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Zip | 19025-1048
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Country | US
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Telephone | 215-441-7700
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Fax | 215-441-4255
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Authorized Official
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Title or Position | PRESIDENT OF GENERAL PARTNER
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Name | MR. PETER J LICARI
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Credential |
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Telephone | 215-441-7700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BN1400X
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Taxonomy Name | Nursing Facility Supplies (DME)
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License Number | 121063
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 332BP3500X
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Taxonomy Name | Parenteral & Enteral Nutrition Supplies (DME)
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License Number | 121063
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 116030
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License Number State | TX
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