Potosi Manor

LBN: Potosi Manor, Inc.
Potosi Manor is an health care organization with primary practice located at 307 S Highway 21 , Potosi MO 63664-9317. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Skilled Nursing Facility, which is considered as the primary health care specialty. Potosi Manor, Inc. can be contacted via phone (573) 438-3225, or through Lincoln, James C via phone (573) 746-7100.

Contact Information

Primary practice address
307 S Highway 21 Potosi MO 63664-9317
Phone: (573) 438-3225
Fax: (573) 438-1230
Website:
Map and Directions
Authorized official contact:
Name: Lincoln, James C
Phone: (573) 746-7100

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Skilled Nursing Facility 314000000X 031634 Missouri

Profile Details

NPI number 1053307322
LBN Legal business name Potosi Manor, Inc.
DBA Doing business as Potosi Manor
Authorized official Lincoln, James C
Entity Organization
Organization subpart 1 No
Enumeration date Sep 22nd, 2005
Last updated Nov 4th, 2011 - about 13 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1053307322 NPPES
Missouri Other 16667131 STATE ID
Missouri MEDICAID 108841503 STATE ID

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