Organization
PENDLETON MANOR INC.
Active
Other names
Pendleton Nursing Home, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RANDALL KROPP (ADMINISTRATOR)
(304) 358-2322
Entity
Organization
Contact information
Practice address
68 GOOD SAMARITAN DRIVE, FRANKLIN, WV 26807-0700
(304) 358-2322
(304) 358-2334
Mailing address
PO BOX 700, 68 GOOD SAMARIAN DRIVE, FRANKLIN, WV 26807-0700
(304) 358-2322
(304) 358-2334
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
66
WV
332BN1400X
Nursing Facility Supplies (DME)
—
—
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0003817000
—
WV
Enumeration date
11/21/2005
Last updated
03/15/2022
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