Provider Demographics
NPI:1073926218
Name:CITY MEDICAL NURSING CENTER
Entity Type:Organization
Organization Name:CITY MEDICAL NURSING CENTER
Other - Org Name:CITY MEDICAL NURSING SERVICES
Other - Org Type:Other Name
Authorized Official - Title/Position:ADMINISTRATION
Authorized Official - Prefix:
Authorized Official - First Name:DOROTHY
Authorized Official - Middle Name:I
Authorized Official - Last Name:FELIX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-759-1191
Mailing Address - Street 1:5340 E MAIN ST STE 212
Mailing Address - Street 2:
Mailing Address - City:WHITEHALL
Mailing Address - State:OH
Mailing Address - Zip Code:43213-2574
Mailing Address - Country:US
Mailing Address - Phone:614-759-1191
Mailing Address - Fax:614-759-1374
Practice Address - Street 1:5340 E MAIN ST
Practice Address - Street 2:212
Practice Address - City:WHITEHALL
Practice Address - State:OH
Practice Address - Zip Code:43213-2574
Practice Address - Country:US
Practice Address - Phone:614-759-1191
Practice Address - Fax:614-759-1374
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-05
Last Update Date:2014-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2510821251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH368065OtherMEDICARE PROVIDER NUMBER
OH2510821Medicaid