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NPI Code Detail

MEDICARE: KARMENTA CENTER, LLC

MEDICARE: KARMENTA CENTER, 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 Facility3123WI

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 : 1386639458
Entity Type Code : Organization
Provider Name (Legal Business Name) : KARMENTA CENTER, LLC
Provider Business Mailing Address
First Line : 110 GLANCY ST STE 114
Second Line :
City : GOODLETTSVILLE
State : TN
Zip : 37072-2314
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4502 MILWAUKEE ST
Second Line :
City : MADISON
State : WI
Zip : 53714-2133
Country : US
Telephone Number : 609-249-2137
Fax Number : 859-281-5150
Authorized Official
Title or Position : PRESIDENT
Name : DOUGLASS B. SMITH
Credential :
Telephone Number : 615-647-9004
Provider Enumeration Date : 09/15/2005
Last Update Date : 10/11/2018

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Directions to “KARMENTA CENTER, LLC ” Practice Location

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