Basic Information
| Provider Information | |||||||||
| NPI: | 1164652327 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MIDWEST CARE GROVE CITY | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2 WISCONSIN CIR | ||||||||
| Address2: | SUITE 540 | ||||||||
| City: | CHEVY CHASE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 208157003 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3019411660 | ||||||||
| FaxNumber: | 3019411661 | ||||||||
| Practice Location | |||||||||
| Address1: | 2320 SONORA DR | ||||||||
| Address2: | |||||||||
| City: | GROVE CITY | ||||||||
| State: | OH | ||||||||
| PostalCode: | 431232423 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6148718000 | ||||||||
| FaxNumber: | 6148718801 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/22/2009 | ||||||||
| LastUpdateDate: | 07/22/2009 | ||||||||
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| AuthorizedOfficialLastName: | MURPHY | ||||||||
| AuthorizedOfficialFirstName: | SEAN | ||||||||
| AuthorizedOfficialMiddleName: | P. | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 3019411690 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 310400000X | Y | Nursing & Custodial Care Facilities | Assisted Living Facility |
No ID Information.