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NPI Code Detail

MEDICARE: DUNWOODY VILLAGE

MEDICARE: DUNWOODY VILLAGE
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 Facility041602PA

General Provider Information

NPI Number : 1548268840
Entity Type Code : Organization
Provider Name (Legal Business Name) : DUNWOODY VILLAGE
Provider Business Mailing Address
First Line : 3500 W CHESTER PIKE
Second Line :
City : NEWTOWN SQUARE
State : PA
Zip : 19073-4101
Country : US
Telephone Number : 610-359-4400
Fax Number : 610-359-4498
Provider Business Practice Location Address
First Line : 3500 W CHESTER PIKE
Second Line :
City : NEWTOWN SQUARE
State : PA
Zip : 19073-4101
Country : US
Telephone Number : 610-359-4400
Fax Number : 610-359-4498
Authorized Official
Title or Position : SR. VICE PRESIDENT
Name : MR. ROBERT L. SUPPER
Credential :
Telephone Number : 610-359-4426
Provider Enumeration Date : 07/11/2005
Last Update Date : 08/22/2020

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Directions to “DUNWOODY VILLAGE ” Practice Location

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