MEDICARE: BISHOP WICKE HEALTH AND REHABILITATION CENTER 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
1	314000000X	Skilled Nursing Facility	812C	CT

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	:	1851428387
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BISHOP WICKE HEALTH AND REHABILITATION CENTER INC

Provider Business Mailing Address
First Line	:	580 LONG HILL AVE
Second Line	:
City	:	SHELTON
State	:	CT
Zip	:	06484-4803
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	580 LONG HILL AVE
Second Line	:
City	:	SHELTON
State	:	CT
Zip	:	06484-4803
Country	:	US
Telephone Number	:	120-394-4828
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DAVID LAWLOR
Credential	:
Telephone Number	:	12039448285

Provider Enumeration Date	:	02/28/2007
Last Update Date	:	07/16/2015

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