MEDICARE: CHESTERWOOD NURSING CARE, LTD.

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	5678	OH

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	:	1962564237
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHESTERWOOD NURSING CARE, LTD.

Provider Business Mailing Address
First Line	:	8073 TYLERSVILLE RD
Second Line	:
City	:	WEST CHESTER
State	:	OH
Zip	:	45069-2589
Country	:	US
Telephone Number	:	513-777-1400
Fax Number	:	513-777-4249

Provider Business Practice Location Address
First Line	:	8073 TYLERSVILLE RD
Second Line	:
City	:	WEST CHESTER
State	:	OH
Zip	:	45069-2589
Country	:	US
Telephone Number	:	513-777-1400
Fax Number	:	513-777-4249

Authorized Official
Title or Position	:	CONTROLLER
Name	:	MR. TIM G. ONTKO
Credential	:
Telephone Number	:	513-326-0005

Provider Enumeration Date	:	12/14/2006
Last Update Date	:	08/22/2020

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