MEDICARE: LITTLE FLOWER MANOR 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	314000000X	Skilled Nursing Facility	121902	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0005602000	OTHER	PA	BLUE CROSS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1477540524
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LITTLE FLOWER MANOR INC

Provider Business Mailing Address
First Line	:	1201 SPRINGFIELD RD
Second Line	:
City	:	DARBY
State	:	PA
Zip	:	19023-1115
Country	:	US
Telephone Number	:	610-534-6000
Fax Number	:	610-534-6027

Provider Business Practice Location Address
First Line	:	1201 SPRINGFIELD RD
Second Line	:
City	:	DARBY
State	:	PA
Zip	:	19023-1115
Country	:	US
Telephone Number	:	610-534-6000
Fax Number	:	610-534-6027

Authorized Official
Title or Position	:	CONTROLLER
Name	:	MS. MICHELE M SUBERS
Credential	:
Telephone Number	:	610-534-6007

Provider Enumeration Date	:	10/04/2005
Last Update Date	:	08/24/2009

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