MEDICARE: WHEATLAND NURSING, 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	N084003	KS

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	:	1790783496
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WHEATLAND NURSING, LLC

Provider Business Mailing Address
First Line	:	320 S LINCOLN ST
Second Line	:
City	:	RUSSELL
State	:	KS
Zip	:	67665-2910
Country	:	US
Telephone Number	:	785-483-5364
Fax Number	:	785-483-4981

Provider Business Practice Location Address
First Line	:	320 S LINCOLN ST
Second Line	:
City	:	RUSSELL
State	:	KS
Zip	:	67665-2910
Country	:	US
Telephone Number	:	785-483-5364
Fax Number	:	785-483-4981

Authorized Official
Title or Position	:	TREASURER
Name	:	MR. JAMES REIKER
Credential	:
Telephone Number	:	573-471-1113

Provider Enumeration Date	:	07/07/2005
Last Update Date	:	01/29/2013

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Directions to “WHEATLAND NURSING, LLC ” Practice Location

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