# PENDLETON MANOR INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Pendleton Nursing Home, Inc.
- **Organization subpart:** No

## Provider details

- **NPI number:** 1750364139
- **Authorized official:** MR. RANDALL KROPP (ADMINISTRATOR)
- **Authorized official phone:** (304) 358-2322

## Contact information

- **Practice address:** 68 GOOD SAMARITAN DRIVE, FRANKLIN, WV 26807-0700
- **Practice address phone:** (304) 358-2322
- **Practice address fax:** (304) 358-2334
- **Mailing address:** PO BOX 700, 68 GOOD SAMARIAN DRIVE, FRANKLIN, WV 26807-0700
- **Mailing address phone:** (304) 358-2322
- **Mailing address fax:** (304) 358-2334

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 66 | WV | Yes |
| 332BN1400X | Nursing Facility Supplies (DME) | — | NULL | — |
| 332BP3500X | Parenteral & Enteral Nutrition Supplies (DME) | — | NULL | — |

## Other

- **Enumeration date:** 11/21/2005
- **Last updated:** 03/15/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0003817000 | — | WV |