1538429907 NPI number — ELSMERE HEALTH FACILITIES LP

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 1538429907 NPI number — ELSMERE HEALTH FACILITIES LP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ELSMERE HEALTH FACILITIES LP
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:
WOODCREST NURSING AND REHABILITATION CENTER
Provider Other Organization Name Type Code:
3
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:
1538429907
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/24/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5420 W PLANO PKWY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PLANO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75093-4823
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
972-931-3800
Provider Business Mailing Address Fax Number:
972-767-6222

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3876 TURKEYFOOT RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ELSMERE
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
41018-2838
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
859-342-8775
Provider Business Practice Location Address Fax Number:
859-342-8701
Provider Enumeration Date:
05/20/2012

Additional Information

Authorized Official

Authorized Official Last Name:
COLLIER
Authorized Official First Name:
JAMIE
Authorized Official Middle Name:
L
Authorized Official Title or Position:
DIRECTOR OF REIMBURSEMENT
Authorized Official Telephone Number:
972-931-3800

Provider Taxonomy Codes

  • Taxonomy code: 314000000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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