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NPI Code Detail

MEDICARE: SENIOR CARE GROUP OF MCDOWELL LLC

MEDICARE: SENIOR CARE GROUP OF MCDOWELL 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 FacilityNH0326NC

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 : 1477537199
Entity Type Code : Organization
Provider Name (Legal Business Name) : SENIOR CARE GROUP OF MCDOWELL LLC
Provider Business Mailing Address
First Line : 1240 MARBELLA PLAZA DRIVE
Second Line :
City : TAMPA
State : FL
Zip : 33619-7904
Country : US
Telephone Number : 813-341-2700
Fax Number : 813-676-0125
Provider Business Practice Location Address
First Line : 306 DEER PARK RD
Second Line :
City : NEBO
State : NC
Zip : 28761-8746
Country : US
Telephone Number : 828-652-3032
Fax Number : 828-656-7224
Authorized Official
Title or Position : CHIEF FINANCIAL OFFICER
Name : MRS. KATHERINE CHUDOW
Credential :
Telephone Number : 813-341-2735
Provider Enumeration Date : 12/06/2005
Last Update Date : 11/21/2011

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