Organization
GLENMARK LIMITED LIABILITY COMPANY I
Active
Other names
Logan Center
Organization subpart
No
Provider details
NPI number
Authorized official
JANE DROPESKEY (CORPORATE MANAGER)
(610) 925-4231
Entity
Organization
Contact information
Practice address
ROUTE 10 THREE MILE CURVE, LOGAN, WV 25601
(304) 752-2273
(304) 752-4167
Mailing address
101 E STATE ST, KENNETT SQUARE, PA 19348-3109
(610) 925-4436
(610) 925-4351
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
127
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0003060000
—
WV
01
—
001703861
MOUNTAIN STATE
—
01
—
281422
UNITED-MAMSI
—
01
—
3061641
AETNA - HMO
—
Enumeration date
06/21/2006
Last updated
06/21/2018
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