MEDICARE: WINCHESTER NURSING CENTER, 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	0828	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	805189	OTHER	MA	TUFTS/SECURE HORIZON
2	2222535701	OTHER	MA	BLUE CROSS BLUE SHIELD
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	903182	OTHER	MA	HARVARD PILGRIM HEALTH

General Provider Information

NPI Number	:	1619971215
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WINCHESTER NURSING CENTER, INC

Provider Business Mailing Address
First Line	:	223 SWANTON ST
Second Line	:
City	:	WINCHESTER
State	:	MA
Zip	:	01890-1968
Country	:	US
Telephone Number	:	781-729-9595
Fax Number	:

Provider Business Practice Location Address
First Line	:	223 SWANTON ST
Second Line	:
City	:	WINCHESTER
State	:	MA
Zip	:	01890-1968
Country	:	US
Telephone Number	:	781-729-9595
Fax Number	:

Authorized Official
Title or Position	:	CHIEF OPERATING OFFICER
Name	:	MR. ROBERT DRISCOLL
Credential	:
Telephone Number	:	781-994-2114

Provider Enumeration Date	:	06/10/2005
Last Update Date	:	02/22/2018

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