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NPI Code Detail

MEDICARE: CHARIOT HARRISBURG SNF OPCO LLC

MEDICARE: CHARIOT HARRISBURG SNF OPCO 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
1314000000XSkilled Nursing Facility

General Provider Information

NPI Number : 1831862762
Entity Type Code : Organization
Provider Name (Legal Business Name) : CHARIOT HARRISBURG SNF OPCO LLC
Provider Business Mailing Address
First Line : 270 WALKER DR
Second Line :
City : STATE COLLEGE
State : PA
Zip : 16801-7097
Country : US
Telephone Number : 814-277-4500
Fax Number :
Provider Business Practice Location Address
First Line : 800 KING RUSS RD
Second Line :
City : HARRISBURG
State : PA
Zip : 17109-5101
Country : US
Telephone Number : 717-657-1520
Fax Number :
Authorized Official
Title or Position : DIR PROVIDER OF CONTRACTING
Name : SHANA K MARK
Credential : MBA
Telephone Number : 814-277-4500
Provider Enumeration Date : 07/27/2021
Last Update Date : 07/27/2021

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