Provider Demographics
NPI:1093349383
Name:EMBASSY WOODVIEW, LLC
Entity Type:Organization
Organization Name:EMBASSY WOODVIEW, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:REPCHICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:571-885-5841
Mailing Address - Street 1:1300 HILL RD N
Mailing Address - Street 2:
Mailing Address - City:PICKERINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43147-8986
Mailing Address - Country:US
Mailing Address - Phone:614-863-1858
Mailing Address - Fax:
Practice Address - Street 1:2770 CLIME RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43223-3626
Practice Address - Country:US
Practice Address - Phone:614-276-8222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-26
Last Update Date:2020-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1834NOtherLICENSURE