MEDICARE: MIAMI COV SNF, 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

General Provider Information

NPI Number	:	1922599729
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MIAMI COV SNF, INC.

Provider Business Mailing Address
First Line	:	75 MOTE DR
Second Line	:
City	:	COVINGTON
State	:	OH
Zip	:	45318-1245
Country	:	US
Telephone Number	:	330-856-4232
Fax Number	:

Provider Business Practice Location Address
First Line	:	75 MOTE DR
Second Line	:
City	:	COVINGTON
State	:	OH
Zip	:	45318-1245
Country	:	US
Telephone Number	:	937-473-2075
Fax Number	:

Authorized Official
Title or Position	:	COO
Name	:	DAN DAMICO
Credential	:
Telephone Number	:	330-856-4232

Provider Enumeration Date	:	05/29/2018
Last Update Date	:	11/27/2023

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