South Fayette Nursing Center, LP
Organization Active NPI Skilled Nursing Facility · Markleysburg, PA
NPI 1366442741 · NPPES record last updated Aug 14, 2014
Key facts
- NPI
- 1366442741
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- License
- 453602 (PA)
- Legal business name
- SOUTH FAYETTE NURSING CENTER, LP
- Practice address
- 252 Main St
Markleysburg, PA 15459-1202 - Phone
- (724) 329-4830
- Fax
- (724) 329-1503
- NPI assigned
- Jul 27, 2005
- Organization subpart
- No
Authorized official
- Name
- Steven D Tack
- Title
- Ceo
- Phone
- (724) 431-0770
National Provider Directory
Locations
252 Main St
#298
Markleysburg, PA 15459
Phone (724) 329-4830
252 Main St
Markleysburg, PA 15459
Phone (724) 329-4830
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 453602 | PA | Yes |
Addresses
Primary practice location
252 Main St
Markleysburg, PA 15459-1202
Mailing address
252 Main St
Markleysburg, PA 15459-1202
Phone (724) 329-4830
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 10360 | Other | GATEWAY HEALTH PLAN | |
| PENDING | Other | PA | HIGHMARK BC |
| 1019298830001 | Medicaid | PA |
Other providers in Markleysburg, PA
- Markleysburg Comm Ambulance
- Kayla Miller
- Stephanie Miller
- Quality Life Services - Henry Clay, LLC
- Quality Life Services - Markleysburg, LLC
- Tess Mikayla Thomas
All providers in Markleysburg, PA · Skilled Nursing Facility in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 14, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.