MEDICARE: SEDGWICK HEALTHCARE INVESTORS, LP

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

General Provider Information

NPI Number	:	1154788214
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SEDGWICK HEALTHCARE INVESTORS, LP

Provider Business Mailing Address
First Line	:	3050 ROYAL BLVD S
Second Line	:	STE. 190
City	:	ALPHARETTA
State	:	GA
Zip	:	30022-4427
Country	:	US
Telephone Number	:	470-282-3268
Fax Number	:	470-268-7957

Provider Business Practice Location Address
First Line	:	5005 E 21ST ST N
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67208-1604
Country	:	US
Telephone Number	:	316-685-9291
Fax Number	:	316-685-2099

Authorized Official
Title or Position	:	PRESIDENT OF MANAGING MEMBER
Name	:	DOUG MITTLEIDER
Credential	:
Telephone Number	:	470-282-3268

Provider Enumeration Date	:	01/20/2016
Last Update Date	:	01/25/2016

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