Provider Demographics
NPI:1548560675
Name:STERLINGTON NURSING HOME SERVICES, INC
Entity Type:Organization
Organization Name:STERLINGTON NURSING HOME SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:E
Authorized Official - Last Name:WHEELER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:318-331-1908
Mailing Address - Street 1:439 WILDWOOD DR
Mailing Address - Street 2:
Mailing Address - City:FARMERVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71241-5215
Mailing Address - Country:US
Mailing Address - Phone:318-331-1908
Mailing Address - Fax:
Practice Address - Street 1:741 WHEELER RD
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:LA
Practice Address - Zip Code:71260-4931
Practice Address - Country:US
Practice Address - Phone:318-331-1908
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-22
Last Update Date:2011-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5DR01Medicare PIN