Organization
BEAVER DAM NURSING & REHAB CENTER, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOUGLAS P COX (PRESIDENT)
(615) 478-6181
Entity
Organization
Contact information
Practice address
1595 US HIGHWAY 231 S, BEAVER DAM, KY 42320-9463
(270) 274-9646
Mailing address
1595 US HIGHWAY 231 S, BEAVER DAM, KY 42320-9463
(270) 274-9646
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
100353
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
12503595
—
KY
05
—
7100125280
—
KY
Enumeration date
11/12/2006
Last updated
08/18/2015
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