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NPI Code Detail

MEDICARE: TANDEM HEALTH CARE OF MT. VERNON, INC.

MEDICARE: TANDEM HEALTH CARE OF MT. VERNON, 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
1314000000XSkilled Nursing Facility0494NOH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1558301812
Entity Type Code : Organization
Provider Name (Legal Business Name) : TANDEM HEALTH CARE OF MT. VERNON, INC.
Provider Business Mailing Address
First Line : 800 CONCOURSE PKWY S
Second Line : SUITE 200
City : MAITLAND
State : FL
Zip : 32751-6148
Country : US
Telephone Number : 407-571-1550
Fax Number : 407-571-1599
Provider Business Practice Location Address
First Line : 416 WOOSTER RD
Second Line :
City : MOUNT VERNON
State : OH
Zip : 43050-1216
Country : US
Telephone Number : 740-397-9626
Fax Number : 740-397-0069
Authorized Official
Title or Position : CHIEF OPERATING OFFICER
Name : JOSEPH CONTE
Credential :
Telephone Number : 407-571-1550
Provider Enumeration Date : 06/07/2006
Last Update Date : 08/22/2020

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