Provider Demographics
NPI:1114925492
Name:THE MEADOWOOD CORPORATION
Entity Type:Organization
Organization Name:THE MEADOWOOD CORPORATION
Other - Org Name:MEADOWOOD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:NORDEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:NHA
Authorized Official - Phone:610-584-3607
Mailing Address - Street 1:3205 SKIPPACK PIKE
Mailing Address - Street 2:PO BOX 670
Mailing Address - City:WORCESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19490-0670
Mailing Address - Country:US
Mailing Address - Phone:610-584-1000
Mailing Address - Fax:610-584-3645
Practice Address - Street 1:3205 SKIPPACK PIKE
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:PA
Practice Address - Zip Code:19490-0670
Practice Address - Country:US
Practice Address - Phone:610-584-1000
Practice Address - Fax:610-584-3645
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-12
Last Update Date:2022-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA771105251E00000X
PA175080310400000X
PA392602314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No251E00000XAgenciesHome Health
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA605498OtherAETNA SNF PROVIDER NUMBER
PA1244OtherBLUE CROSS PROVIDER NUMBE
PA71-01050OtherEVERCARE PROVIDER NUMBER
PA39-7711Medicare ID - Type UnspecifiedHOME HEALTH
PA39-5768Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
PA397711Medicare Oscar/Certification
PA605498OtherAETNA SNF PROVIDER NUMBER