Provider Demographics
NPI:1952300220
Name:MACINTOSH COMPANY
Entity Type:Organization
Organization Name:MACINTOSH COMPANY
Other - Org Name:PICKAWAY MANOR CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:CURT
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-345-9526
Mailing Address - Street 1:3863 TRUEMAN CT
Mailing Address - Street 2:
Mailing Address - City:HILLIARD
Mailing Address - State:OH
Mailing Address - Zip Code:43026-2496
Mailing Address - Country:US
Mailing Address - Phone:614-345-9500
Mailing Address - Fax:614-345-6810
Practice Address - Street 1:391 CLARK DR
Practice Address - Street 2:
Practice Address - City:CIRCLEVILLE
Practice Address - State:OH
Practice Address - Zip Code:43113-1561
Practice Address - Country:US
Practice Address - Phone:740-474-6036
Practice Address - Fax:740-420-3342
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-19
Last Update Date:2013-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5388313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH147479Medicaid
OH147479Medicaid