# CANTERBURY OF SHEPHERDSTOWN, LP

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Canterbury Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1619921277
- **Authorized official:** JANE DROPESKEY (CORPORATE MANAGER)
- **Authorized official phone:** (610) 925-4231

## Contact information

- **Practice address:** 80 MADDEX DR, SHEPHERDSTOWN, WV 25443-4305
- **Practice address phone:** (304) 876-9422
- **Practice address fax:** (304) 876-6869
- **Mailing address:** 101 E STATE ST, KENNETT SQUARE, PA 19348-3109
- **Mailing address phone:** (610) 925-4436
- **Mailing address fax:** (610) 925-4351

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 133 | WV | Yes |

## Other

- **Enumeration date:** 05/19/2006
- **Last updated:** 06/21/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0003509000 | — | WV |
| 01 | — | 000399209 | MOUNTAIN STATE BC/BS | WV |
| 01 | — | 02SS | CAREFIRST - PROV/INQ \# | MD |
| 01 | — | 268528 | UNITED HEALTHCARE-MAMSI | MD |
| 01 | — | 3126610 | AETNA - HMO | WV |
| 01 | — | PX9 | CAREFIRST - IND/PPO | DC |
| 01 | — | PX9 | CAREFIRST - BLUE CHOICE | MD |