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NPI Code Detail

MEDICARE: QLS CLEARFIELD LLC

MEDICARE: QLS CLEARFIELD 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 Facility

General Provider Information

NPI Number : 1497261507
Entity Type Code : Organization
Provider Name (Legal Business Name) : QLS CLEARFIELD LLC
Provider Business Mailing Address
First Line : 612 N MAIN ST
Second Line :
City : BUTLER
State : PA
Zip : 16001-4363
Country : US
Telephone Number : 724-431-0770
Fax Number :
Provider Business Practice Location Address
First Line : 700 LEONARD ST
Second Line :
City : CLEARFIELD
State : PA
Zip : 16830-3245
Country : US
Telephone Number : 724-431-0770
Fax Number :
Authorized Official
Title or Position : CFO
Name : DEAN RIPPEE
Credential :
Telephone Number : 724-431-0770
Provider Enumeration Date : 12/27/2017
Last Update Date : 12/27/2017

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