MEDICARE: SHILOH SPRINGS 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
1	314000000X	Skilled Nursing Facility	4996	OH

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	:	1396749057
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SHILOH SPRINGS CARE CENTER

Provider Business Mailing Address
First Line	:	3500 SHILOH SPRINGS RD
Second Line	:
City	:	TROTWOOD
State	:	OH
Zip	:	45426-2260
Country	:	US
Telephone Number	:	937-854-1180
Fax Number	:	937-854-0209

Provider Business Practice Location Address
First Line	:	3500 SHILOH SPRINGS RD
Second Line	:
City	:	TROTWOOD
State	:	OH
Zip	:	45426-2260
Country	:	US
Telephone Number	:	937-854-1180
Fax Number	:	937-854-0209

Authorized Official
Title or Position	:	OWNER
Name	:	MR. JOE BARNETT
Credential	:
Telephone Number	:	937-854-1180

Provider Enumeration Date	:	06/10/2005
Last Update Date	:	08/22/2020

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