MEDICARE: FOX NURSING HOME, 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	3	WV
2	313M00000X	Nursing Facility/Intermediate Care Facility	3	WV

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

General Provider Information

NPI Number	:	1598766867
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FOX NURSING HOME, INC

Provider Business Mailing Address
First Line	:	125 FOX LN
Second Line	:
City	:	CHESTER
State	:	WV
Zip	:	26034-1601
Country	:	US
Telephone Number	:	304-387-0101
Fax Number	:	304-387-1522

Provider Business Practice Location Address
First Line	:	125 FOX LN
Second Line	:
City	:	CHESTER
State	:	WV
Zip	:	26034-1601
Country	:	US
Telephone Number	:	304-387-0101
Fax Number	:	304-387-1522

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	JAMES D. FOX
Credential	:
Telephone Number	:	304-387-0101

Provider Enumeration Date	:	08/09/2005
Last Update Date	:	03/09/2010

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Directions to “FOX NURSING HOME, INC ” Practice Location

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