MEDICARE: DOUBLE R AND ASSOC., 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

General Provider Information

NPI Number	:	1518299353
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DOUBLE R AND ASSOC., INC

Provider Business Mailing Address
First Line	:	S7559 USH 12
Second Line	:
City	:	NORTH FREEDOM
State	:	WI
Zip	:	53951-9532
Country	:	US
Telephone Number	:	608-643-6910
Fax Number	:	608-643-8640

Provider Business Practice Location Address
First Line	:	S7559 US HIGHWAY 12
Second Line	:
City	:	NORTH FREEDOM
State	:	WI
Zip	:	53951-9532
Country	:	US
Telephone Number	:	608-643-6910
Fax Number	:	608-643-8640

Authorized Official
Title or Position	:	ADMINISTRATOR/OWNER
Name	:	MR. DOWARD K RICHARD
Credential	:
Telephone Number	:	608-643-6910

Provider Enumeration Date	:	02/04/2010
Last Update Date	:	02/04/2010

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Directions to “DOUBLE R AND ASSOC., INC ” Practice Location

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