MEDICARE: WINTERFEST MEDICAL SERVICES CORPORATION

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	:	1528667581
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WINTERFEST MEDICAL SERVICES CORPORATION

Provider Business Mailing Address
First Line	:	8758 WINTERFEST WAY
Second Line	:
City	:	ELK GROVE
State	:	CA
Zip	:	95624-1295
Country	:	US
Telephone Number	:	916-284-4129
Fax Number	:	916-244-7162

Provider Business Practice Location Address
First Line	:	8758 WINTERFEST WAY
Second Line	:
City	:	ELK GROVE
State	:	CA
Zip	:	95624-1295
Country	:	US
Telephone Number	:	916-284-4129
Fax Number	:	916-244-7162

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MRS. JANET AGUSTIN
Credential	:
Telephone Number	:	916-284-4129

Provider Enumeration Date	:	10/21/2020
Last Update Date	:	10/21/2020

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