MEDICARE: MEADOWVIEW MANOR REHABILITATION SERVICES, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	225X00000X	Occupational Therapist
2	235Z00000X	Speech-Language Pathologist
3	225100000X	Physical Therapist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	02662700	OTHER	PA	CAPITAL BLUE CROSS
2	516506	OTHER	PA	BLUE SHIELD
3	52044	OTHER	PA	GEISINGER

General Provider Information

NPI Number	:	1457329294
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEADOWVIEW MANOR REHABILITATION SERVICES, INC.

Provider Business Mailing Address
First Line	:	14330 CROGHAN PIKE
Second Line	:
City	:	MOUNT UNION
State	:	PA
Zip	:	17066
Country	:	US
Telephone Number	:	814-542-8630
Fax Number	:	814-542-2828

Provider Business Practice Location Address
First Line	:	14330 CROGHAN PIKE
Second Line	:
City	:	MOUNT UNION
State	:	PA
Zip	:	17066
Country	:	US
Telephone Number	:	814-542-8630
Fax Number	:	814-542-2828

Authorized Official
Title or Position	:	CLINICAL SUPERVISOR
Name	:	BRANDI PARKES
Credential	:
Telephone Number	:	814-542-8630

Provider Enumeration Date	:	03/09/2006
Last Update Date	:	08/04/2016

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Directions to “MEADOWVIEW MANOR REHABILITATION SERVICES, INC. ” Practice Location

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