Provider Demographics
NPI:1568722643
Name:RICHMOND HEALTH FACILITIES - MADISON LP
Entity Type:Organization
Organization Name:RICHMOND HEALTH FACILITIES - MADISON LP
Other - Org Name:MADISON HEALTH AND REHABILITATION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF REIMBURSEMENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:L
Authorized Official - Last Name:COLLIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-931-3800
Mailing Address - Street 1:5420 W PLANO PKWY
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-4823
Mailing Address - Country:US
Mailing Address - Phone:972-931-3800
Mailing Address - Fax:972-767-6222
Practice Address - Street 1:131 MEADOWLARK DR
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:KY
Practice Address - Zip Code:40475-2235
Practice Address - Country:US
Practice Address - Phone:859-623-3564
Practice Address - Fax:859-625-3070
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-22
Last Update Date:2013-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
185262Medicare Oscar/Certification