Provider Demographics
NPI:1083606719
Name:COMMUNITY NURSING SERVICES INC.
Entity Type:Organization
Organization Name:COMMUNITY NURSING SERVICES INC.
Other - Org Name:PIONEER TRACE NURSING HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BUSINESS OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:C
Authorized Official - Last Name:SAVAGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:606-845-2131
Mailing Address - Street 1:115 PIONEER TRCE
Mailing Address - Street 2:
Mailing Address - City:FLEMINGSBURG
Mailing Address - State:KY
Mailing Address - Zip Code:41041-9665
Mailing Address - Country:US
Mailing Address - Phone:606-845-2131
Mailing Address - Fax:606-845-3507
Practice Address - Street 1:115 PIONEER TRCE
Practice Address - Street 2:
Practice Address - City:FLEMINGSBURG
Practice Address - State:KY
Practice Address - Zip Code:41041-9665
Practice Address - Country:US
Practice Address - Phone:606-845-2131
Practice Address - Fax:606-845-3507
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-18
Last Update Date:2015-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY100484314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY12502407Medicaid
KY12502407Medicaid