Provider Demographics
NPI:1467449546
Name:COZY CORNER NURSING HOME INC
Entity Type:Organization
Organization Name:COZY CORNER NURSING HOME INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:J
Authorized Official - Last Name:BEDNARSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:413-665-2740
Mailing Address - Street 1:61 OLD AMHERST RD
Mailing Address - Street 2:PO BOX 405
Mailing Address - City:SUNDERLAND
Mailing Address - State:MA
Mailing Address - Zip Code:01375-7501
Mailing Address - Country:US
Mailing Address - Phone:413-665-2740
Mailing Address - Fax:413-665-5027
Practice Address - Street 1:61 OLD AMHERST RD
Practice Address - Street 2:
Practice Address - City:SUNDERLAND
Practice Address - State:MA
Practice Address - Zip Code:01375-7501
Practice Address - Country:US
Practice Address - Phone:413-665-2740
Practice Address - Fax:413-665-5027
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA0039314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0910805Medicaid
225714Medicare ID - Type Unspecified