MEDICARE: LYNN MEDICAL INVESTORS LTD PTR

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	0925	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	71-00252	OTHER	MA	EVERCARE PLAN
2	724665	OTHER	MA	TUFTS HEALTH PLANS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	HARBARD PILGRIM	OTHER	MA	905071

General Provider Information

NPI Number	:	1225036080
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LYNN MEDICAL INVESTORS LTD PTR

Provider Business Mailing Address
First Line	:	3001 KEITH ST NW
Second Line	:
City	:	CLEVELAND
State	:	TN
Zip	:	37312-3713
Country	:	US
Telephone Number	:	423-473-5751
Fax Number	:	423-339-8342

Provider Business Practice Location Address
First Line	:	111 BIRCH ST
Second Line	:
City	:	LYNN
State	:	MA
Zip	:	01902-1574
Country	:	US
Telephone Number	:	781-592-9667
Fax Number	:	781-599-6590

Authorized Official
Title or Position	:	ASSISTANT SECRETARY
Name	:	CINDY S CROSS
Credential	:
Telephone Number	:	423-473-5867

Provider Enumeration Date	:	07/14/2005
Last Update Date	:	03/05/2009

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