WC- Olney Eg Ops, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

WC- OLNEY EG OPS, LLC

Practice address

1301 N East St
Olney, IL 62450-2430

Phone

(618) 395-4663

Fax

(618) 392-6313

NPI assigned

Jan 8, 2015

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Stephanie Ervin

Title

Business Office Manager

Phone

(618) 395-4663

Specialties & licenses 1

Addresses

Other names 1

• Emerald Glen Olney Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1420675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1420675200000",
    "number": "1164810420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 N EAST ST",
            "city": "OLNEY",
            "state": "IL",
            "postal_code": "624502430",
            "telephone_number": "618-395-4663",
            "fax_number": "618-392-6313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 N EAST ST",
            "city": "OLNEY",
            "state": "IL",
            "postal_code": "624502430",
            "telephone_number": "618-395-4663",
            "fax_number": "618-392-6313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WC- OLNEY EG OPS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-08",
        "last_updated": "2015-01-08",
        "status": "A",
        "authorized_official_last_name": "ERVIN",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "BUSINESS OFFICE MANAGER",
        "authorized_official_telephone_number": "618-395-4663",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Emerald Glen Olney",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility in Olney, IL
• Providers in Olney, IL by specialty
• Assisted Living Facility in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.