Organization
CARRIAGE INN OF BOWERSTON INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JANA SMITH (CORPORATE AR DIRECTOR)
(937) 277-0505
Entity
Organization
Contact information
Practice address
102 BOYCE DR, BOWERSTON, OH 44695-9701
(740) 269-8001
(740) 269-1733
Mailing address
102 BOYCE DR, P.O. BOX 261, BOWERSTON, OH 44695-9701
(740) 269-8001
(740) 269-1733
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
5964
OH
314000000X
Skilled Nursing Facility
Primary
5964
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2283998
—
OH
Enumeration date
10/04/2005
Last updated
03/13/2012
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