Provider Demographics
NPI:1083612634
Name:BETHEL NURSING HOME COMPANY, INC
Entity Type:Organization
Organization Name:BETHEL NURSING HOME COMPANY, INC
Other - Org Name:BETHEL NURSING HOME INC.
Other - Org Type:Other Name
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:ANASTASIOS
Authorized Official - Middle Name:
Authorized Official - Last Name:MARKOPOULOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-739-6700
Mailing Address - Street 1:67 SPRINGVALE RD
Mailing Address - Street 2:
Mailing Address - City:CROTON
Mailing Address - State:NY
Mailing Address - Zip Code:10520-1343
Mailing Address - Country:US
Mailing Address - Phone:914-739-6700
Mailing Address - Fax:914-736-0092
Practice Address - Street 1:17 NARRAGANSETT AVE
Practice Address - Street 2:
Practice Address - City:OSSINING
Practice Address - State:NY
Practice Address - Zip Code:10562-2843
Practice Address - Country:US
Practice Address - Phone:914-941-1300
Practice Address - Fax:914-941-4281
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-08
Last Update Date:2014-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00931879Medicaid
337211Medicare UPIN