Organization
MED-SYSTEMS OF FRANKLIN FURNACE, LLC
Active
Other names
Fountainhead Nursing Home
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL L DAFFIN (COO)
(419) 526-0124
Entity
Organization
Contact information
Practice address
4734 GALLIA PIKE, FRANKLIN FURNACE, OH 45629-8600
(419) 512-1711
Mailing address
4734 GALLIA PIKE, FRANKLIN FURNACE, OH 45629-8600
(419) 526-0124
(419) 522-4391
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
1179
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0081291
—
OH
Enumeration date
03/26/2013
Last updated
06/05/2013
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