1124027503 NPI number — MCGIRR NURSING HOME INC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1124027503 NPI number — MCGIRR NURSING HOME INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MCGIRR NURSING HOME INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1124027503
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
33 ATKINSON ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BELLOWS FALLS
Provider Business Mailing Address State Name:
VT
Provider Business Mailing Address Postal Code:
05101
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
802-463-4387
Provider Business Mailing Address Fax Number:
802-463-9670

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
33 ATKINSON ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BELLOWS FALLS
Provider Business Practice Location Address State Name:
VT
Provider Business Practice Location Address Postal Code:
05101-1502
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
802-463-4387
Provider Business Practice Location Address Fax Number:
802-463-9670
Provider Enumeration Date:
07/19/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
PERRY
Authorized Official First Name:
MARGARET
Authorized Official Middle Name:
Authorized Official Title or Position:
ADMINISTRATOR
Authorized Official Telephone Number:
802-463-4387

Provider Taxonomy Codes

  • Taxonomy code: 313M00000X , registered in the state of VT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0475054 , issued by the state of ( VT ) . This identifiers is of the category "MEDICAID".