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NPI Code Detail

MEDICARE: WALDORF SNF OPERATIONS LLC

MEDICARE: WALDORF SNF 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 Facility08006MD

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 : 1285605378
Entity Type Code : Organization
Provider Name (Legal Business Name) : WALDORF SNF OPERATIONS LLC
Provider Business Mailing Address
First Line : 101 E STATE ST
Second Line :
City : KENNETT SQUARE
State : PA
Zip : 19348-3109
Country : US
Telephone Number : 610-925-4436
Fax Number : 610-925-4351
Provider Business Practice Location Address
First Line : 4140 OLD WASHINGTON HIGHWAY
Second Line :
City : WALDORF
State : MD
Zip : 20602-3221
Country : US
Telephone Number : 301-645-2813
Fax Number :
Authorized Official
Title or Position : CORPORATE MANAGER
Name : JANE DROPESKEY
Credential :
Telephone Number : 610-925-4231
Provider Enumeration Date : 01/27/2006
Last Update Date : 11/16/2011

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