Presbyterian Homes in the Presbytery of Lake Erie

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

680202 Issued in PA

Legal business name

PRESBYTERIAN HOMES IN THE PRESBYTERY OF LAKE ERIE

Practice address

2628 Elmwood Ave
Erie, PA 16508-1421

Phone

(814) 864-4802

Fax

(814) 864-7044

NPI assigned

Jul 20, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Gary C Seib

Title

Vice President / Cfo

Phone

(814) 314-1718

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Elmwood Gardens Other name

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

{
    "created_epoch": "1121817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1368748800000",
    "number": "1508865627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 SCHOOL RD",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165052691",
            "telephone_number": "814-314-1718",
            "fax_number": "814-314-1749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2628 ELMWOOD AVE",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165081421",
            "telephone_number": "814-864-4802",
            "fax_number": "814-864-7044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESBYTERIAN HOMES IN THE PRESBYTERY OF LAKE ERIE",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-20",
        "last_updated": "2013-05-17",
        "status": "A",
        "authorized_official_last_name": "SEIB",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "VICE PRESIDENT / CFO",
        "authorized_official_telephone_number": "814-314-1718",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "PA",
            "license": "680202",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK/KHPW",
            "identifier": "0660",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007538560006",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Elmwood Gardens",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Presbyterian Homes in the Presbytery of Lake Erie
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• Skilled Nursing Facility in Erie, PA
• Providers in Erie, 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 17, 2013; 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.