Manor Care of Pottsville PA LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

383802 Issued in PA

Legal business name

MANOR CARE OF POTTSVILLE PA LLC

Doing business as

ManorCare Health Services - Pottsville

Practice address

420 Pulaski Dr
Pottsville, PA 17901-3634

Phone

(570) 622-9582

Fax

(570) 622-9594

NPI assigned

May 27, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Martin D Allen

Title

Director

Phone

(419) 252-5743

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• ManorCare Health Services - Pottsville Doing business as

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

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1494288000000",
    "number": "1508813460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 N SUMMIT ST",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436042615",
            "telephone_number": "419-252-5500",
            "fax_number": "877-385-9446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 PULASKI DR",
            "city": "POTTSVILLE",
            "state": "PA",
            "postal_code": "179013634",
            "telephone_number": "570-622-9582",
            "fax_number": "570-622-9594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANOR CARE OF POTTSVILLE PA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-27",
        "last_updated": "2017-05-09",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "419-252-5743",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "PA",
            "license": "383802",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1020615090001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ManorCare Health Services - Pottsville",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Carol A Malarkey, CRNA
• Maqsood Ahmad Malik, MD
• Brian Malloy, D.C
• Philip Malloy, LPT
• Gretchen Manbeck
• Faran Mansoor, MD
• Frances Judith Lago Manus, M.D.
• Jillian Ann Marcalus, BSN
• Amanda L Marchetti, PTA
• Christopher Marcolla

• Skilled Nursing Facility in Pottsville, PA
• Providers in Pottsville, PA by specialty
• Skilled Nursing Facility in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2017; 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.