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NPI Code Detail

MEDICARE: PHC-CLEVELAND INC.

MEDICARE: PHC-CLEVELAND INC.
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 Facility151MS

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1000080746OTHERMSBLUE CROSS/SNF
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1316984453
Entity Type Code : Organization
Provider Name (Legal Business Name) : PHC-CLEVELAND INC.
Provider Business Mailing Address
First Line : 330 SEVEN SPRINGS WAY
Second Line :
City : BRENTWOOD
State : TN
Zip : 37027-4536
Country : US
Telephone Number : 615-920-7000
Fax Number : 615-920-8913
Provider Business Practice Location Address
First Line : 901 E SUNFLOWER RD
Second Line :
City : CLEVELAND
State : MS
Zip : 38732-2833
Country : US
Telephone Number : 662-846-0061
Fax Number : 662-846-2380
Authorized Official
Title or Position : VICE PRESIDENT, CORPORATE SECRETARY
Name : KATHY TEAGUE
Credential :
Telephone Number : 629-253-5121
Provider Enumeration Date : 05/31/2006
Last Update Date : 03/11/2024

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Directions to “PHC-CLEVELAND INC. ” Practice Location

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