MEDICARE: N & R OF SEYMOUR, 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	029208	MO

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	16780817	OTHER	MO	STATE ID

General Provider Information

NPI Number	:	1689660987
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	N & R OF SEYMOUR, INC.

Provider Business Mailing Address
First Line	:	851 W THOROUGHFARE ST
Second Line	:
City	:	SEYMOUR
State	:	MO
Zip	:	65746-8767
Country	:	US
Telephone Number	:	417-935-2992
Fax Number	:	417-935-2321

Provider Business Practice Location Address
First Line	:	851 W THOROUGHFARE ST
Second Line	:
City	:	SEYMOUR
State	:	MO
Zip	:	65746-8767
Country	:	US
Telephone Number	:	417-935-2992
Fax Number	:	417-935-2321

Authorized Official
Title or Position	:	SHAREHOLDER
Name	:	MR. JAMES C LINCOLN
Credential	:
Telephone Number	:	573-746-7100

Provider Enumeration Date	:	09/22/2005
Last Update Date	:	11/04/2011

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