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NPI Code Detail

MEDICARE: UVMC NURSING CARE INC

MEDICARE: UVMC NURSING CARE 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
1291U00000XClinical Medical Laboratory36D0726684OH

General Provider Information

NPI Number : 1508027392
Entity Type Code : Organization
Provider Name (Legal Business Name) : UVMC NURSING CARE INC
Provider Business Mailing Address
First Line : 4375 S COUNTY ROAD 25A
Second Line :
City : TIPP CITY
State : OH
Zip : 45371-2956
Country : US
Telephone Number : 937-667-7500
Fax Number :
Provider Business Practice Location Address
First Line : 4375 S COUNTY ROAD 25A
Second Line :
City : TIPP CITY
State : OH
Zip : 45371-2956
Country : US
Telephone Number : 937-667-7500
Fax Number :
Authorized Official
Title or Position : PRESIDENT CEO
Name : GARY WADE
Credential :
Telephone Number : 937-964-8974
Provider Enumeration Date : 06/24/2008
Last Update Date : 06/24/2008

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