Organization
CONCORD CARE CENTER OF HARTFORD, INC.
Active
Other names
Meadowbrook Manor
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DEBRA A IFFT CPA (CEO)
(330) 759-2357
Entity
Organization
Contact information
Practice address
3090 FIVE POINTS HARTFORD RD, FOWLER, OH 44418-9726
(330) 772-5253
(330) 772-7771
Mailing address
3090 FIVE POINTS HARTFORD RD, FOWLER, OH 44418-9726
(330) 772-5253
(330) 772-7771
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
5645
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000334532
ANTHEM
OH
01
—
1497831606
MEDICARE DME SUPPLIER NPI
OH
05
—
2109677
—
OH
Enumeration date
11/04/2005
Last updated
07/12/2007
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