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NPI Code Detail

MEDICARE: PIKETON FACILITY OPERATIONS, LLC

MEDICARE: PIKETON FACILITY OPERATIONS, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1314000000XSkilled Nursing Facility

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1003820127
Entity Type Code : Organization
Provider Name (Legal Business Name) : PIKETON FACILITY OPERATIONS, LLC
Provider Business Mailing Address
First Line : 800 CONCOURSE PKWY S
Second Line : SUITE 200
City : MAITLAND
State : FL
Zip : 32751-6148
Country : US
Telephone Number : 407-571-1550
Fax Number : 407-571-1599
Provider Business Practice Location Address
First Line : 300 OVERLOOK DR
Second Line :
City : PIKETON
State : OH
Zip : 45661-9760
Country : US
Telephone Number : 740-289-4074
Fax Number : 740-289-4581
Authorized Official
Title or Position : CHIEF EXECUTIVE OFFICER
Name : JOSEPH CONTE
Credential :
Telephone Number : 407-571-1550
Provider Enumeration Date : 07/27/2006
Last Update Date : 10/15/2007

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Directions to “PIKETON FACILITY OPERATIONS, LLC ” Practice Location

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