Wedgewood Nursing Home
LBN: Wedgewood Nursing Home, L.P.
Wedgewood Nursing Home is an health care organization with primary practice located at 6621 Dan Danciger Rd , Fort Worth TX 76133-4905. The organization recently has 3 registered licenses in different health care specialties including Nursing & Custodial Care Facilities / Skilled Nursing Facility, Suppliers / Nursing Facility Supplies, Suppliers / Parenteral & Enteral Nutrition. Nursing & Custodial Care Facilities / Skilled Nursing Facility is the primary health care specialty.
Wedgewood Nursing Home, L.P. can be contacted via phone (817) 292-6330, or through Licari, Peter J via phone (215) 441-7700.
Contact Information
Primary practice address
6621 Dan Danciger Rd
Fort Worth TX 76133-4905
Phone: (817) 292-6330
Fax: (817) 346-7980
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Nursing & Custodial Care Facilities / Skilled Nursing Facility | 314000000X | 115374 | Texas |
| Suppliers / Nursing Facility Supplies | 332BN1400X | 115374 | Texas |
| Suppliers / Parenteral & Enteral Nutrition | 332BP3500X | 115374 | Texas |
Profile Details
| NPI number | 1174575625 |
|---|---|
| LBN Legal business name | Wedgewood Nursing Home, L.P. |
| DBA Doing business as | Wedgewood Nursing Home |
| Authorized official | Licari, Peter J |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | May 16th, 2006 |
| Last updated | Oct 30th, 2007 - about 17 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1174575625 | NPPES |
| Texas | MEDICAID | 004960 |
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