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NPI Code Detail

MEDICARE: ELLEN MEMORIAL HEALTH CARE CENTER

MEDICARE: ELLEN MEMORIAL HEALTH CARE CENTER
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 Facility318502PA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1366446288
Entity Type Code : Organization
Provider Name (Legal Business Name) : ELLEN MEMORIAL HEALTH CARE CENTER
Provider Business Mailing Address
First Line : 23 ELLEN MEMORIAL LN
Second Line :
City : HONESDALE
State : PA
Zip : 18431-4096
Country : US
Telephone Number : 570-253-5690
Fax Number : 570-253-9471
Provider Business Practice Location Address
First Line : 23 ELLEN MEMORIAL LN
Second Line :
City : HONESDALE
State : PA
Zip : 18431-4096
Country : US
Telephone Number : 570-253-5690
Fax Number : 570-253-9471
Authorized Official
Title or Position : ADMINISTRATOR
Name : MR. ROBERT G ZABADY
Credential :
Telephone Number : 570-253-5690
Provider Enumeration Date : 06/09/2005
Last Update Date : 08/22/2020

Similar Medicare Providers

1427182575 — LISA MARIE WEBB
Practice Location Address:
23 ELLEN MEMORIAL LN
HONESDALE, PA
18431-4096
Practice Phone: 570-253-5690
Practice Fax: 570-253-4512
1972628311 — MRS. EMEBET TILAHUN GIREF MSPT
Practice Location Address:
23 ELLEN MEMORIAL LN
HONESDALE, PA
18431-4096
Practice Phone: 579-253-5690
Practice Fax:
1043336100 — MRS. ELAINE MARGARET FELIX OTA
Practice Location Address:
23 ELLEN MEMORIAL LN
HONESDALE, PA
18431-4096
Practice Phone: 570-253-5691
Practice Fax:
1568580462 — MISS MELISSA MARIE GIBBLETS MS, OTRL
Practice Location Address:
23 ELLEN MEMORIAL LN
HONESDALE, PA
18431-4096
Practice Phone: 570-253-5690
Practice Fax:
1750596896 — DANA M GRAZIUL M.S. CCC-SLP
Practice Location Address:
23 ELLEN MEMORIAL LN
HONESDALE, PA
18431-4096
Practice Phone: 570-253-5690
Practice Fax:
1942763297 — ELLEN MEMORIAL, LLC
Practice Location Address:
23 ELLEN MEMORIAL LN
HONESDALE, PA
18431-4096
Practice Phone: 570-253-5690
Practice Fax:

Directions to “ELLEN MEMORIAL HEALTH CARE CENTER ” Practice Location

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