Organization
WOOD RIVER PROPERTY LLC
Active
Other names
Wood River Village Nursing Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GERARD MCEVILLY NHA (EXECUTIVE DIRECTOR)
(215) 752-2370
Entity
Organization
Contact information
Practice address
3200 BENSALEM BLVD, BENSALEM, PA 19020-1956
(215) 752-2370
(215) 752-1672
Mailing address
3200 BENSALEM BLVD, BENSALEM, PA 19020-1956
(215) 752-2370
(215) 752-1672
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
233802
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0002078000
INDEPENDENCE BLUE CROSS
PA
01
—
5312656
AETNA
PA
Enumeration date
10/05/2005
Last updated
05/22/2012
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