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NPI Code Detail

MEDICARE: GUARDIAN ELDER CARE AT COLUMBUS I LLC

MEDICARE: GUARDIAN ELDER CARE AT COLUMBUS I 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 Facility

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 : 1386994671
Entity Type Code : Organization
Provider Name (Legal Business Name) : GUARDIAN ELDER CARE AT COLUMBUS I LLC
Provider Business Mailing Address
First Line : 8796 ROUTE 219
Second Line :
City : BROCKWAY
State : PA
Zip : 15824-6010
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2425 KIMBERLY PKWY E
Second Line :
City : COLUMBUS
State : OH
Zip : 43232-4271
Country : US
Telephone Number : 614-868-9306
Fax Number :
Authorized Official
Title or Position : CFO
Name : MICHAEL EPERESI
Credential :
Telephone Number : 814-265-1164
Provider Enumeration Date : 09/13/2012
Last Update Date : 08/25/2020

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