# MEDA NIPPLE CONVALESCENT HOME

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1649267477
- **Authorized official:** MRS. KATHLEEN TEKLA NIPPLE (ASSISTANT ADMINISTRATOR)
- **Authorized official phone:** (717) 463-2632

## Contact information

- **Practice address:** RR 1 BOX 109, THOMPSONTOWN, PA 17094-9722
- **Practice address phone:** (717) 463-2632
- **Practice address fax:** (775) 255-4723
- **Mailing address:** RR 1 BOX 109, THOMPSONTOWN, PA 17094-9722
- **Mailing address phone:** (717) 463-2632
- **Mailing address fax:** (775) 255-4723

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 131802 | PA | Yes |

## Other

- **Enumeration date:** 10/06/2005
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0007547340001 | — | PA |