Provider Demographics
NPI:1275962888
Name:N & R OF HARTVILLE, LLC
Entity Type:Organization
Organization Name:N & R OF HARTVILLE, LLC
Other - Org Name:HARTVILLE CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:C
Authorized Official - Last Name:LINCOLN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-481-9625
Mailing Address - Street 1:649 W ROLLA ST
Mailing Address - Street 2:
Mailing Address - City:HARTVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:65667-8221
Mailing Address - Country:US
Mailing Address - Phone:471-741-6192
Mailing Address - Fax:417-741-7828
Practice Address - Street 1:649 W ROLLA ST
Practice Address - Street 2:
Practice Address - City:HARTVILLE
Practice Address - State:MO
Practice Address - Zip Code:65667-8221
Practice Address - Country:US
Practice Address - Phone:471-741-6192
Practice Address - Fax:417-741-7828
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-04
Last Update Date:2013-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO265593Medicare Oscar/Certification