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NPI Code Detail

MEDICARE: CSC ENTERPRISES, INC.

MEDICARE: CSC ENTERPRISES, 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 Facility997CCT

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 : 1366445629
Entity Type Code : Organization
Provider Name (Legal Business Name) : CSC ENTERPRISES, INC.
Provider Business Mailing Address
First Line : 189 ALPS RD
Second Line :
City : BRANFORD
State : CT
Zip : 06405-4771
Country : US
Telephone Number : 203-481-6221
Fax Number : 203-483-1893
Provider Business Practice Location Address
First Line : 189 ALPS RD
Second Line :
City : BRANFORD
State : CT
Zip : 06405-4771
Country : US
Telephone Number : 203-481-6221
Fax Number : 203-483-1893
Authorized Official
Title or Position : ADMINISTRATOR
Name : MR. STEPHEN JONES SHELTON
Credential : M.P.H.
Telephone Number : 203-481-6221
Provider Enumeration Date : 05/31/2005
Last Update Date : 12/11/2007

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Directions to “CSC ENTERPRISES, INC. ” Practice Location

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