Provider Demographics
NPI:1558342329
Name:FOX NURSING HOME CORP
Entity Type:Organization
Organization Name:FOX NURSING HOME CORP
Other - Org Name:DBA FOX SUBACUTE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:WALT
Authorized Official - Middle Name:
Authorized Official - Last Name:DUNSMORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-862-0630
Mailing Address - Street 1:2644 BRISTOL ROAD
Mailing Address - Street 2:
Mailing Address - City:WARRINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:18976
Mailing Address - Country:US
Mailing Address - Phone:215-343-2700
Mailing Address - Fax:610-862-0614
Practice Address - Street 1:2644 BRISTOL ROAD
Practice Address - Street 2:
Practice Address - City:WARRINGTON
Practice Address - State:PA
Practice Address - Zip Code:18976
Practice Address - Country:US
Practice Address - Phone:215-343-2700
Practice Address - Fax:215-343-8761
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-09
Last Update Date:2008-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0005653000OtherBLUE CROSS
PA001613392001Medicaid
PA001613392001Medicaid