Organization
GOSPORT CARE, INC.
Active
Other names
Gosport Nursing Home
Organization subpart
No
Provider details
NPI number
Authorized official
MR. FRED J PONTON (OWNER,ADMINISTRATOR)
(812) 879-4242
Entity
Organization
Contact information
Practice address
27 S. 7TH ST., GOSPORT, IN 47433-0099
(812) 879-4242
(812) 879-4633
Mailing address
PO BOX 99, GOSPORT, IN 47433-0099
(812) 879-4242
(812) 879-4633
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
06000409-1
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
15E281
—
IN
Enumeration date
06/13/2007
Last updated
05/29/2008
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