MEDICARE: CHAMBERS COUNTY

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	001025803	TX

Other Identifiers

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

General Provider Information

NPI Number	:	1598156341
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHAMBERS COUNTY

Provider Business Mailing Address
First Line	:	PO BOX 7230
Second Line	:
City	:	VICTORIA
State	:	TX
Zip	:	77903-7230
Country	:	US
Telephone Number	:	361-576-9454
Fax Number	:	361-576-2994

Provider Business Practice Location Address
First Line	:	1215 HIGHWAY 124
Second Line	:
City	:	WINNIE
State	:	TX
Zip	:	77665-9005
Country	:	US
Telephone Number	:	409-296-8200
Fax Number	:	409-296-8212

Authorized Official
Title or Position	:	MANAGER
Name	:	MR. MICHAEL W WHITLEY
Credential	:
Telephone Number	:	361-576-9454

Provider Enumeration Date	:	02/16/2015
Last Update Date	:	11/23/2015

Similar Medicare Providers

1508863515 — THE ARBORETUM NURSING AND REHABILITATION CENTER OF WINNIE, INC.
Practice Location Address:

1215 HIGHWAY 124
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1699773226 — DR. LEONIDAS S ANDRES M.D.
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1881688042 — DR. MICHAEL LYONS DO
Practice Location Address:

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1295781227 — WINNIE COMMUNITY HOSPITAL, LLC
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1295776805 — MR. DANNY LEE THOMPSON PA-C
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1306887534 — DR. WILLIAM CLAY BROWN MD
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Directions to “CHAMBERS COUNTY ” Practice Location

Language	Start Address	Practice Location

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