Basic Information
| Provider Information | |||||||||
| NPI: | 1558658963 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | COVENTRY SKILLED NURSING AND REHAB | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10 WOODLAND DRIVE | ||||||||
| Address2: | |||||||||
| City: | COVENTRY | ||||||||
| State: | RI | ||||||||
| PostalCode: | 02816 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4018262000 | ||||||||
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| Practice Location | |||||||||
| Address1: | 10 WOODLAND DRIVE | ||||||||
| Address2: | |||||||||
| City: | COVENTRY | ||||||||
| State: | RI | ||||||||
| PostalCode: | 02816 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4018262000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/06/2011 | ||||||||
| LastUpdateDate: | 07/06/2011 | ||||||||
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| AuthorizedOfficialLastName: | LEWIS | ||||||||
| AuthorizedOfficialFirstName: | KERRI | ||||||||
| AuthorizedOfficialMiddleName: | KATHLEEN | ||||||||
| AuthorizedOfficialTitleorPosition: | PHYSICAL THERAPIST ASSISTANT | ||||||||
| AuthorizedOfficialTelephone: | 4018262000 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MISS | ||||||||
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| AuthorizedOfficialCredential: | PTA | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 314000000X | PTA00568 | RI | Y | Nursing & Custodial Care Facilities | Skilled Nursing Facility |
No ID Information.