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NPI Code Detail

MEDICARE: CLAY COUNTY MANOR

MEDICARE: CLAY COUNTY MANOR
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 Facility0000000036TN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1699815399
Entity Type Code : Organization
Provider Name (Legal Business Name) : CLAY COUNTY MANOR
Provider Business Mailing Address
First Line : 120 PITCOCK LN
Second Line :
City : CELINA
State : TN
Zip : 38551-4058
Country : US
Telephone Number : 931-243-3139
Fax Number : 931-243-3169
Provider Business Practice Location Address
First Line : 120 PITCOCK LN
Second Line :
City : CELINA
State : TN
Zip : 38551-4058
Country : US
Telephone Number : 931-243-3139
Fax Number : 931-243-3169
Authorized Official
Title or Position : OFFICE MANAGER
Name : MRS. JUDY LYNN MEADOWS
Credential :
Telephone Number : 931-243-3139
Provider Enumeration Date : 02/08/2007
Last Update Date : 08/22/2020

Similar Medicare Providers

1073555421 — INTEGRITY HEALTHCARE OF CELINA, LLC
Practice Location Address:
120 PITCOCK LN
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1659846491 — HEATHER BUSSELL
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Practice Fax:
1982176129 — WHITNEY FARREN NEWBERRY
Practice Location Address:
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Practice Fax:
1619440948 — ASHLEY MAE COPELAND COTA/L
Practice Location Address:
120 PITCOCK LN
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38551-4058
Practice Phone: 931-243-3139
Practice Fax:
1649807827 — PAMELA JOANE HEAD
Practice Location Address:
120 PITCOCK LN
CELINA, TN
38551-4058
Practice Phone: 931-243-3139
Practice Fax:
1558009613 — HANNA TURNER CF-SLP
Practice Location Address:
120 PITCOCK LN
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38551-4058
Practice Phone: 931-243-3139
Practice Fax:

Directions to “CLAY COUNTY MANOR ” Practice Location

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