Provider Demographics
NPI:1417936949
Name:RHA/PENNSYLVANIA NURSING HOMES INC.
Entity Type:Organization
Organization Name:RHA/PENNSYLVANIA NURSING HOMES INC.
Other - Org Name:PEMBROOKE HEALTH & REHABILITATION RESIDENCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:J
Authorized Official - Last Name:SCIOLE
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:215-558-3700
Mailing Address - Street 1:1130 W CHESTER PIKE
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19382-5005
Mailing Address - Country:US
Mailing Address - Phone:610-692-3636
Mailing Address - Fax:610-344-4949
Practice Address - Street 1:1130 W CHESTER PIKE
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19382-5005
Practice Address - Country:US
Practice Address - Phone:610-692-3636
Practice Address - Fax:610-344-4949
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-12
Last Update Date:2012-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA230602314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA100728085001Medicaid
PA395166BMedicare ID - Type Unspecified