1841634938 NPI number — WESTON CARE CENTER, LLC

Table of content: (NPI 1841634938)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841634938 NPI number — WESTON CARE CENTER, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WESTON CARE CENTER, LLC
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:
WESTON REHABILITATION & NURSING 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:
1841634938
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/19/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2222 SULLIVAN TRL
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
EASTON
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
18040-7958
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-438-2020
Provider Business Mailing Address Fax Number:
610-438-2024

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1896 LEITHSVILLE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HELLERTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18055-2505
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-838-7901
Provider Business Practice Location Address Fax Number:
610-838-6663
Provider Enumeration Date:
04/19/2013

Additional Information

Authorized Official

Authorized Official Last Name:
WESTON
Authorized Official First Name:
RANDALL
Authorized Official Middle Name:
A.
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
484-239-2963

Provider Taxonomy Codes

  • Taxonomy code: 313M00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • 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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