MEDICARE: MEADOW GROVE CITY, 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
1	314000000X	Skilled Nursing Facility

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1326407339
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEADOW GROVE CITY, INC.

Provider Business Mailing Address
First Line	:	25000 COUNTRY CLUB BLVD STE 255
Second Line	:
City	:	NORTH OLMSTED
State	:	OH
Zip	:	44070-5337
Country	:	US
Telephone Number	:	440-793-2245
Fax Number	:

Provider Business Practice Location Address
First Line	:	5919 BLUE STAR DR
Second Line	:
City	:	GROVE CITY
State	:	OH
Zip	:	43123-7595
Country	:	US
Telephone Number	:	330-204-1040
Fax Number	:

Authorized Official
Title or Position	:	CORPORATE SECRETARY
Name	:	SANDY MUIR
Credential	:
Telephone Number	:	440-793-2245

Provider Enumeration Date	:	02/18/2016
Last Update Date	:	06/02/2026

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Directions to “MEADOW GROVE CITY, INC. ” Practice Location

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