MEDICARE: CANAL WINCHESTER CARE CENTER, LLC

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

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	:	1619486230
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CANAL WINCHESTER CARE CENTER, LLC

Provider Business Mailing Address
First Line	:	6800 GENDER RD
Second Line	:
City	:	CANAL WINCHESTER
State	:	OH
Zip	:	43110-8282
Country	:	US
Telephone Number	:	614-834-6800
Fax Number	:	380-200-6397

Provider Business Practice Location Address
First Line	:	6800 GENDER RD
Second Line	:
City	:	CANAL WINCHESTER
State	:	OH
Zip	:	43110-8282
Country	:	US
Telephone Number	:	614-834-6800
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	LASHONDA CAMPBELL
Credential	:
Telephone Number	:	614-834-6800

Provider Enumeration Date	:	09/26/2017
Last Update Date	:	06/04/2026

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