Provider Demographics
NPI:1760420368
Name:NHC HEALTHCARE-MARYLAND HEIGHTS LLC
Entity Type:Organization
Organization Name:NHC HEALTHCARE-MARYLAND HEIGHTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SVP
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:USSERY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-890-2020
Mailing Address - Street 1:2920 FEE FEE RD
Mailing Address - Street 2:
Mailing Address - City:MARYLAND HEIGHTS
Mailing Address - State:MO
Mailing Address - Zip Code:63043-1915
Mailing Address - Country:US
Mailing Address - Phone:314-291-0121
Mailing Address - Fax:
Practice Address - Street 1:2920 FEE FEE RD
Practice Address - Street 2:
Practice Address - City:MARYLAND HEIGHTS
Practice Address - State:MO
Practice Address - Zip Code:63043-1915
Practice Address - Country:US
Practice Address - Phone:314-291-0121
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NATIONAL HEALTHCARE CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-03
Last Update Date:2008-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO031078314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO13423OtherBCBS
43754OtherGHP
MO110502OtherBCBS
7100054OtherUNITED
7100054OtherUNITED