Organization
SOUTH COUNTY NURSING HOME, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SAWSAN MAKHAMREH (ADMINISTRATOR)
(636) 296-5455
Entity
Organization
Contact information
Practice address
1101 W OUTER 21 RD, ARNOLD, MO 63010-4644
(636) 296-5455
(636) 296-5086
Mailing address
1101 W OUTER 21 RD, ARNOLD, MO 63010-4644
(636) 296-5455
(636) 296-5086
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
031860
MO
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
44219300001
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101451508
—
MO
Enumeration date
02/13/2007
Last updated
10/21/2011
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