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NPI Code Detail

MEDICARE: BROOMALL HEALTHCARE GROUP, INC.

MEDICARE: BROOMALL HEALTHCARE GROUP, 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
1314000000XSkilled Nursing Facility

Other Identifiers

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

General Provider Information

NPI Number : 1821261710
Entity Type Code : Organization
Provider Name (Legal Business Name) : BROOMALL HEALTHCARE GROUP, INC.
Provider Business Mailing Address
First Line : 23700 COMMERCE PARK
Second Line :
City : BEACHWOOD
State : OH
Zip : 44122-5827
Country : US
Telephone Number : 216-292-5706
Fax Number :
Provider Business Practice Location Address
First Line : 43 CHURCH LN
Second Line :
City : BROOMALL
State : PA
Zip : 19008-2503
Country : US
Telephone Number : 610-356-3003
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : WILLIAM I WEISBERG
Credential :
Telephone Number : 216-292-5706
Provider Enumeration Date : 04/11/2008
Last Update Date : 01/10/2022

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