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NPI Code Detail

MEDICARE: BENCHMARK HEALTHCARE OF MONETT, LLC

MEDICARE: BENCHMARK HEALTHCARE OF MONETT, 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 : 1922329960
Entity Type Code : Organization
Provider Name (Legal Business Name) : BENCHMARK HEALTHCARE OF MONETT, LLC
Provider Business Mailing Address
First Line : 17826 EDISON AVE
Second Line :
City : CHESTERFIELD
State : MO
Zip : 63005-1262
Country : US
Telephone Number : 636-536-5365
Fax Number : 636-536-4533
Provider Business Practice Location Address
First Line : 410 W BENTON ST
Second Line :
City : MONETT
State : MO
Zip : 65708-1608
Country : US
Telephone Number : 417-235-6031
Fax Number : 417-235-8676
Authorized Official
Title or Position : PRESIDENT
Name : MR. JOHN M. SELLS
Credential :
Telephone Number : 636-536-5365
Provider Enumeration Date : 06/14/2010
Last Update Date : 11/08/2013

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