Provider Demographics
NPI:1942245006
Name:MARKGLEN, INC.
Entity Type:Organization
Organization Name:MARKGLEN, INC.
Other - Org Name:SHENANDOAH HEALTH VILLAGE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CORPORATE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JANE
Authorized Official - Middle Name:
Authorized Official - Last Name:DROPESKEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-925-4231
Mailing Address - Street 1:101 E STATE ST
Mailing Address - Street 2:
Mailing Address - City:KENNETT SQUARE
Mailing Address - State:PA
Mailing Address - Zip Code:19348-3109
Mailing Address - Country:US
Mailing Address - Phone:610-925-4436
Mailing Address - Fax:610-925-4351
Practice Address - Street 1:50 MULBERRY TREE STREET
Practice Address - Street 2:
Practice Address - City:CHARLES TOWN
Practice Address - State:WV
Practice Address - Zip Code:25414-1170
Practice Address - Country:US
Practice Address - Phone:304-724-1101
Practice Address - Fax:304-724-1105
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-20
Last Update Date:2018-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV138314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
250762OtherAETNA-HMO
282248OtherUNITED - MAMSI
027BOtherCAREFIRST PROV/INQ#
PY4OtherCAREFIRST - IND/PPO
PY4OtherCAREFIRST - BLUECHOICE
WV0003718000Medicaid
PY4OtherCAREFIRST - IND/PPO
=========OtherCIGNA-MIDATLANTIC
PY4OtherCAREFIRST - BLUECHOICE
=========OtherCIGNA-WV
=========OtherHNFS-TRICARE
027BOtherCAREFIRST PROV/INQ#
=========OtherMARYLAND PHYSICIAN CARE
WV0003718000Medicaid
=========OtherCARELINK