Provider Demographics
NPI:1972590651
Name:SMITH HEALTH CARE LTD
Entity Type:Organization
Organization Name:SMITH HEALTH CARE LTD
Other - Org Name:SMITH NURSING & CONVALESCENT HOME INC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:NURSING HOME ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:L
Authorized Official - Last Name:STRITTMATTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-868-3664
Mailing Address - Street 1:453 S MAIN RD
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN TOP
Mailing Address - State:PA
Mailing Address - Zip Code:18707-1944
Mailing Address - Country:US
Mailing Address - Phone:570-868-3664
Mailing Address - Fax:570-868-7644
Practice Address - Street 1:453 S MAIN RD
Practice Address - Street 2:
Practice Address - City:MOUNTAIN TOP
Practice Address - State:PA
Practice Address - Zip Code:18707-1944
Practice Address - Country:US
Practice Address - Phone:570-868-3664
Practice Address - Fax:570-868-7644
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-29
Last Update Date:2016-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA453102314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000757146Medicaid
PA0000395716Medicare ID - Type Unspecified