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NPI Code Detail

MEDICARE: N & R OF CEDAR HILL

MEDICARE: N & R OF CEDAR HILL
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 Facility031642MO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11876993OTHERMOSTATE ID

General Provider Information

NPI Number : 1508852963
Entity Type Code : Organization
Provider Name (Legal Business Name) : N & R OF CEDAR HILL
Provider Business Mailing Address
First Line : 6400 THE CEDARS CT
Second Line :
City : CEDAR HILL
State : MO
Zip : 63016-2220
Country : US
Telephone Number : 636-274-1777
Fax Number : 636-274-4041
Provider Business Practice Location Address
First Line : 6400 THE CEDARS CT
Second Line :
City : CEDAR HILL
State : MO
Zip : 63016-2220
Country : US
Telephone Number : 636-274-1777
Fax Number : 636-274-4041
Authorized Official
Title or Position : COO CFO
Name : THOMAS HUDSPETH
Credential :
Telephone Number : 573-392-0316
Provider Enumeration Date : 09/21/2005
Last Update Date : 08/22/2020

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