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NPI Code Detail

MEDICARE: PRESBYTERIAN HOMES IN THE PRESBYTERY OF LAKE ERIE

MEDICARE: PRESBYTERIAN HOMES IN THE PRESBYTERY OF LAKE ERIE
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 Facility424402PA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10694OTHERPAHIGHMARK/KHPW

General Provider Information

NPI Number : 1841202504
Entity Type Code : Organization
Provider Name (Legal Business Name) : PRESBYTERIAN HOMES IN THE PRESBYTERY OF LAKE ERIE
Provider Business Mailing Address
First Line : 1225 SCHOOL RD
Second Line :
City : ERIE
State : PA
Zip : 16505-2691
Country : US
Telephone Number : 814-314-1718
Fax Number : 814-314-1749
Provider Business Practice Location Address
First Line : 10 VO TECH DR
Second Line :
City : OIL CITY
State : PA
Zip : 16301-3502
Country : US
Telephone Number : 814-676-8686
Fax Number : 814-677-9349
Authorized Official
Title or Position : VICE PRESIDENT / CFO
Name : MR. GARY C. SEIB
Credential :
Telephone Number : 814-314-1718
Provider Enumeration Date : 08/12/2006
Last Update Date : 05/17/2013

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Directions to “PRESBYTERIAN HOMES IN THE PRESBYTERY OF LAKE ERIE ” Practice Location

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