Provider Demographics
NPI:1912932534
Name:NHC HEALTHCARE-ST. CHARLES LLC
Entity Type:Organization
Organization Name:NHC HEALTHCARE-ST. CHARLES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MEL
Authorized Official - Middle Name:
Authorized Official - Last Name:RECTOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:636-946-3677
Mailing Address - Street 1:35 SUGAR MAPLE LN
Mailing Address - Street 2:
Mailing Address - City:SAINT CHARLES
Mailing Address - State:MO
Mailing Address - Zip Code:63303-5740
Mailing Address - Country:US
Mailing Address - Phone:636-946-8887
Mailing Address - Fax:
Practice Address - Street 1:35 SUGAR MAPLE LN
Practice Address - Street 2:
Practice Address - City:SAINT CHARLES
Practice Address - State:MO
Practice Address - Zip Code:63303-5740
Practice Address - Country:US
Practice Address - Phone:636-946-8887
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NATIONAL HEALTHCARE CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-12
Last Update Date:2008-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO032228314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
7100055OtherUNITED HEALTH CARE
MO130010OtherBC BS
265166Medicare Oscar/Certification