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NPI Code Detail

MEDICARE: MONROE NURSING HOME INC

MEDICARE: MONROE NURSING HOME 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
1314000000XSkilled Nursing Facility11471218GA

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 : 1972518611
Entity Type Code : Organization
Provider Name (Legal Business Name) : MONROE NURSING HOME INC
Provider Business Mailing Address
First Line : 1865 BOLD SPRINGS RD NW
Second Line :
City : MONROE
State : GA
Zip : 30656-4605
Country : US
Telephone Number : 770-267-8677
Fax Number : 770-267-7831
Provider Business Practice Location Address
First Line : 1865 BOLD SPRINGS RD NW
Second Line :
City : MONROE
State : GA
Zip : 30656-4605
Country : US
Telephone Number : 770-267-8677
Fax Number : 770-267-7831
Authorized Official
Title or Position : ADMINISTRATOR
Name : MR. E KENNETH MURRAY JR.
Credential :
Telephone Number : 770-267-8677
Provider Enumeration Date : 07/30/2006
Last Update Date : 04/02/2015

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Directions to “MONROE NURSING HOME INC ” Practice Location

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