# BIRCHWOOD NURSING & REHAB CTR

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

## Provider details

- **NPI number:** 1790782217
- **Authorized official:** SAM KRAVETZ (C.F.O.)
- **Authorized official phone:** (732) 942-1344

## Contact information

- **Practice address:** 395 E MIDDLE RD, NANTICOKE, PA 18634-3806
- **Practice address phone:** (570) 735-2973
- **Practice address fax:** (570) 735-8420
- **Mailing address:** 395 E MIDDLE ROAD, NANTICOKE, PA 18634-3806
- **Mailing address phone:** (570) 735-2973
- **Mailing address fax:** (570) 735-8420

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 026402 | PA | Yes |

## Other

- **Enumeration date:** 06/30/2005
- **Last updated:** 01/30/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0009420910001 | — | PA |