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NPI Code Detail

MEDICARE: COUNTRY MEADOWS OF SOUTH HILLS ASSOCIATES

MEDICARE: COUNTRY MEADOWS OF SOUTH HILLS ASSOCIATES
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 Facility125402PA

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 : 1841290731
Entity Type Code : Organization
Provider Name (Legal Business Name) : COUNTRY MEADOWS OF SOUTH HILLS ASSOCIATES
Provider Business Mailing Address
First Line : 830 CHERRY DR
Second Line :
City : HERSHEY
State : PA
Zip : 17033-2007
Country : US
Telephone Number : 717-533-0723
Fax Number : 717-533-1014
Provider Business Practice Location Address
First Line : 3590 WASHINGTON PIKE
Second Line :
City : BRIDGEVILLE
State : PA
Zip : 15017-1047
Country : US
Telephone Number : 412-257-2474
Fax Number : 412-257-0358
Authorized Official
Title or Position : VP- FINANCE, ACCOUNTING, INFO SRVS
Name : MR. VINCENT J. MIZAK
Credential : CPA
Telephone Number : 717-533-0723
Provider Enumeration Date : 07/21/2005
Last Update Date : 10/04/2011

Similar Medicare Providers

1225153208 — MR. ANTHONY RYAN CHAPLA P.T.
Practice Location Address:
3590 WASHINGTON PIKE
BRIDGEVILLE, PA
15017-1047
Practice Phone: 412-257-2474
Practice Fax:
1366568537 — WENDY MARIE MUSSOMELI PTA
Practice Location Address:
3590 WASHINGTON PIKE
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1346366341 — ANNA STEVENS
Practice Location Address:
3590 WASHINGTON PIKE
BRIDGEVILLE, PA
15017-1047
Practice Phone: 412-257-2474
Practice Fax:
1073639274 — MRS. MICHELE ANNETTE NICHOLS C.O.T.A
Practice Location Address:
3590 WASHINGTON PIKE
BRIDGEVILLE, PA
15017-1047
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Practice Fax:
1215053319 — AMY W SHELHAMER OTR
Practice Location Address:
3590 WASHINGTON PIKE
BRIDGEVILLE, PA
15017-1047
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Practice Fax:
1255457354 — MRS. ADRIEN LEIGH PEDERSON OTR
Practice Location Address:
3590 WASHINGTON PIKE
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Directions to “COUNTRY MEADOWS OF SOUTH HILLS ASSOCIATES ” Practice Location

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