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5040 PHILADELPHIA DRIVE OPERATING COMPANY INC

Nursing/Intermediate Care Facility

Dayton, Ohio

Provider NPI: 1255328662

Organization Information:
Organization Name:  5040 PHILADELPHIA DRIVE OPERATING COMPANY INC


Practice Location:
5040 PHILADELPHIA DR  DAYTON, OH 45415 US
Tel: 937-278-0404  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y313M00000XNursing & Custodial Care Facilities
Nursing Facility/Intermediate Care Facility
OH1923N

Other Provider Identifiers:

IssuerNumberStateType
2524450OH05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin




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