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NPI Code Detail

MEDICARE: CRESTVIEW OPERATING COMPANY, INC.

MEDICARE: CRESTVIEW OPERATING COMPANY, 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 Facility2241NOH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
22241NOTHEROHNURSING HOME LICENSE #

General Provider Information

NPI Number : 1497750863
Entity Type Code : Organization
Provider Name (Legal Business Name) : CRESTVIEW OPERATING COMPANY, INC.
Provider Business Mailing Address
First Line : 68637 BANNOCK RD
Second Line :
City : SAINT CLAIRSVILLE
State : OH
Zip : 43950-9736
Country : US
Telephone Number : 740-695-2500
Fax Number : 740-695-5969
Provider Business Practice Location Address
First Line : 68637 BANNOCK RD
Second Line :
City : SAINT CLAIRSVILLE
State : OH
Zip : 43950-9736
Country : US
Telephone Number : 740-695-2500
Fax Number : 740-695-5969
Authorized Official
Title or Position : PRESIDENT
Name : MR. THOMAS D NORDQUIST
Credential :
Telephone Number : 330-726-6047
Provider Enumeration Date : 06/14/2005
Last Update Date : 09/19/2007

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Directions to “CRESTVIEW OPERATING COMPANY, INC. ” Practice Location

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