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NPI Code Detail

MEDICARE: CRESTVIEW CONVALESCENT HOME, INC.

MEDICARE: CRESTVIEW CONVALESCENT HOME, 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
1314000000XSkilled Nursing Facility034402PA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10005831000OTHERIBC
2116OTHERELDER HEALTH
30005831000OTHERAMERIHEALTH
41046877OTHERKEYSTONE MERCY
520678OTHERHEALTH PARTNERS
6255069OTHERHEALTH AMERICA
7MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8317144OTHERUS FAMILY HEALTH PLAN
9IY0229OTHERHEALTHNET OF PA
1013144OTHERAETNA-HMO

General Provider Information

NPI Number : 1457392235
Entity Type Code : Organization
Provider Name (Legal Business Name) : CRESTVIEW CONVALESCENT HOME, INC.
Provider Business Mailing Address
First Line : 101 E STATE ST
Second Line :
City : KENNETT SQUARE
State : PA
Zip : 19348-3109
Country : US
Telephone Number : 610-925-4436
Fax Number : 610-925-4351
Provider Business Practice Location Address
First Line : 1245 CHURCH RD
Second Line :
City : WYNCOTE
State : PA
Zip : 19095-1800
Country : US
Telephone Number : 215-884-9990
Fax Number : 215-884-5579
Authorized Official
Title or Position : CORPORATE MANAGER
Name : JANE DROPESKEY
Credential :
Telephone Number : 610-925-4231
Provider Enumeration Date : 06/10/2006
Last Update Date : 06/21/2018

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