MEDICARE: ZANDEX HEALTH CARE CORPORATION

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
1	314000000X	Skilled Nursing Facility	5094	OH
2	314000000X	Skilled Nursing Facility	2062N	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	5094	OTHER	OH	FACILITY LICENSE NUMBER
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1063403582
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ZANDEX HEALTH CARE CORPORATION

Provider Business Mailing Address
First Line	:	PO BOX 730
Second Line	:	1122 TAYLOR STREET
City	:	ZANESVILLE
State	:	OH
Zip	:	43702-0730
Country	:	US
Telephone Number	:	740-454-1400
Fax Number	:	740-454-7439

Provider Business Practice Location Address
First Line	:	1280 FRIENDSHIP DR
Second Line	:
City	:	NEW CONCORD
State	:	OH
Zip	:	43762-1024
Country	:	US
Telephone Number	:	740-872-0809
Fax Number	:	740-826-9101

Authorized Official
Title or Position	:	VP CFO
Name	:	MR. LYLE W CLARK
Credential	:	CFO
Telephone Number	:	740-454-1400

Provider Enumeration Date	:	11/03/2005
Last Update Date	:	05/10/2017

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Directions to “ZANDEX HEALTH CARE CORPORATION ” Practice Location

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