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NPI Code Detail

MEDICARE: ST JOHN NEUMANN NURSING HOME

MEDICARE: ST JOHN NEUMANN NURSING HOME
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 Facility452202PA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
20535127OTHERPAAETNA
3005944OTHERPAIBC KEYSTONE

General Provider Information

NPI Number : 1134103419
Entity Type Code : Organization
Provider Name (Legal Business Name) : ST JOHN NEUMANN NURSING HOME
Provider Business Mailing Address
First Line : 10400 ROOSEVELT BLVD
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19116-3905
Country : US
Telephone Number : 215-698-5600
Fax Number : 215-698-5755
Provider Business Practice Location Address
First Line : 10400 ROOSEVELT BLVD
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19116-3905
Country : US
Telephone Number : 215-698-5600
Fax Number : 215-698-5755
Authorized Official
Title or Position : CHIEF FINANCIAL OFFICER
Name : MR. MICHAEL CZENER
Credential :
Telephone Number : 215-368-0900
Provider Enumeration Date : 12/01/2005
Last Update Date : 06/16/2008

Similar Medicare Providers

1205903630 — ST JOHN NEUMANN NURSING HOME
Practice Location Address:
10400 ROOSEVELT BLVD
PHILADELPHIA, PA
19116-3905
Practice Phone: 215-698-5600
Practice Fax: 215-368-5254
1144345216 — JILL CHEGUS PTA
Practice Location Address:
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19116-3905
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Practice Fax:
1720103302 — CHRISTINE M. FREDERICKS P.T.
Practice Location Address:
10400 ROOSEVELT BLVD
PHILADELPHIA, PA
19116-3905
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Practice Fax:
1104010750 — HONG HA THI NGUYEN OTR/L
Practice Location Address:
10400 ROOSEVELT BLVD
PHILADELPHIA, PA
19116-3905
Practice Phone: 215-698-5641
Practice Fax: 215-698-2749
1043487473 — NE PHYSICIAN SERVICES INC
Practice Location Address:
10400 ROOSEVELT BLVD
PHILADELPHIA, PA
19116-3905
Practice Phone: 215-333-6888
Practice Fax:
1770894537 — DAVIDA LIGHTSEY M.A., CCC-SLP
Practice Location Address:
10400 ROOSEVELT BLVD , REHAB DEPT
PHILADELPHIA, PA
19116-3905
Practice Phone: 215-698-5784
Practice Fax:

Directions to “ST JOHN NEUMANN NURSING HOME ” Practice Location

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