Provider Demographics
NPI:1356441257
Name:CAMDEN NURSING FACILITY INC
Entity Type:Organization
Organization Name:CAMDEN NURSING FACILITY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ELDRIDGE
Authorized Official - Middle Name:B
Authorized Official - Last Name:STEWART
Authorized Official - Suffix:
Authorized Official - Credentials:ADMINISTRATOR
Authorized Official - Phone:334-682-4231
Mailing Address - Street 1:550 PONDEROSA DR
Mailing Address - Street 2:P.O. BOX 787
Mailing Address - City:CAMDEN
Mailing Address - State:AL
Mailing Address - Zip Code:36726-0787
Mailing Address - Country:US
Mailing Address - Phone:334-682-4231
Mailing Address - Fax:334-682-5224
Practice Address - Street 1:550 PONDEROSA DR
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:AL
Practice Address - Zip Code:36726-0787
Practice Address - Country:US
Practice Address - Phone:334-682-4231
Practice Address - Fax:334-682-5224
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-22
Last Update Date:2012-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL4757170SMedicaid
AL015374Medicare Oscar/Certification