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NPI Code Detail

MEDICARE: NATHAN HEALTH CARE CENTER, L.L.C.

MEDICARE: NATHAN HEALTH CARE CENTER, L.L.C.
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
1314000000XSkilled Nursing Facility

General Provider Information

NPI Number : 1699073874
Entity Type Code : Organization
Provider Name (Legal Business Name) : NATHAN HEALTH CARE CENTER, L.L.C.
Provider Business Mailing Address
First Line : 1869 CRAIG PARK CT
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63146-4122
Country : US
Telephone Number : 314-543-3800
Fax Number : 314-543-3880
Provider Business Practice Location Address
First Line : 5050 SUMMIT AVE
Second Line :
City : EAST SAINT LOUIS
State : IL
Zip : 62203-1026
Country : US
Telephone Number : 618-874-3597
Fax Number : 618-874-0240
Authorized Official
Title or Position : DIRECTOR OF FINANCE
Name : MR. ASHWIN DUNDOO
Credential :
Telephone Number : 314-543-3800
Provider Enumeration Date : 03/11/2011
Last Update Date : 04/04/2013

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Directions to “NATHAN HEALTH CARE CENTER, L.L.C. ” Practice Location

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