Organization
KINGSTON OF VERMILION, LLC
Active
Other names
Kingston of Vermilion
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LARRY NIRSCHL (TREASURER)
(419) 247-2824
Entity
Organization
Contact information
Practice address
4210 TELEGRAPH LN, VERMILION, OH 44089-3748
(440) 967-1800
(440) 967-0122
Mailing address
PO BOX 2165, TOLEDO, OH 43603-2165
(419) 247-2880
(419) 247-2872
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
1806N
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000228658
ANTHEM
OH
05
—
2611221
—
OH
Enumeration date
10/03/2005
Last updated
08/22/2020
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