MEDICARE: ANTHONY COMMUNITY CARE CENTER, 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
1	313M00000X	Nursing Facility/Intermediate Care Facility	N039001	KS

General Provider Information

NPI Number	:	1396792925
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANTHONY COMMUNITY CARE CENTER, INC.

Provider Business Mailing Address
First Line	:	212 N 5TH AVE
Second Line	:
City	:	ANTHONY
State	:	KS
Zip	:	67003-2106
Country	:	US
Telephone Number	:	620-842-5187
Fax Number	:

Provider Business Practice Location Address
First Line	:	212 N 5TH AVE
Second Line	:
City	:	ANTHONY
State	:	KS
Zip	:	67003-2106
Country	:	US
Telephone Number	:	620-842-5187
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MS. MARGARET P. RADER
Credential	:
Telephone Number	:	620-842-5187

Provider Enumeration Date	:	05/28/2006
Last Update Date	:	02/15/2008

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