Guardian Elder Care at Nanticoke II LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

GUARDIAN ELDER CARE AT NANTICOKE II LLC

Practice address

395 Middle Rd
Nanticoke, PA 18634-3806

Phone

(570) 735-2973

NPI assigned

Sep 28, 2018

Organization subpart

No

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

Authorized official

Name

Michael Eperesi

Title

Cfo

Phone

(814) 265-1164

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Birchwood Healthcare and Rehabilitation Center Doing business as

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

{
    "created_epoch": "1538092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598313600000",
    "number": "1992280671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8796 ROUTE 219",
            "city": "BROCKWAY",
            "state": "PA",
            "postal_code": "158246010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "395 MIDDLE RD",
            "city": "NANTICOKE",
            "state": "PA",
            "postal_code": "186343806",
            "telephone_number": "570-735-2973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUARDIAN ELDER CARE AT NANTICOKE II LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-28",
        "last_updated": "2020-08-25",
        "certification_date": "2020-08-25",
        "status": "A",
        "authorized_official_last_name": "EPERESI",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "814-265-1164"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103569456-0001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Birchwood Healthcare and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Birchwood Healthcare and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lucia Civiletti Gray, OTR/L
• Greater Nanticoke Area School District
• Marissa Greene
• Deric Grohowski, DC
• Joseph Paul Gronka, D.M.D.
• Guardian Elder Care at Nanticoke LLC
• Guardian Long Term Care Pharmacy Inc
• Heather Lasco Nutrition LLC
• Melanie Hill
• Richard A Hiscox, DO

• Skilled Nursing Facility in Nanticoke, PA
• Providers in Nanticoke, 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 Aug 25, 2020; 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.