Revera (Delaware) Llc in Puyallup - Skilled Nursing Facility
Revera (Delaware) Llc - NPI 1417959875
Revera (Delaware) Llc is a Skilled Nursing Facility in Puyallup, Washington. Revera (Delaware) Llc practices all healthcare services and medical treatments related to Skilled Nursing Facility. The NPI Number for Revera (Delaware) Llc is 1417959875. The last update date is 2011-05-19.
Revera (Delaware) Llc's current location address is 400 29th Street Ne, Puyallup, Washington. You can contact this provider via phone number 2538404400 and fax number 2538406733. The mailing address for Revera (Delaware) Llc is 400 29th Street Ne, Puyallup, Washington. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Revera (Delaware) Llc |
|---|---|
| Address | 400 29th Street Ne, Puyallup, Washington |
| Phone Number | 2538404400 |
| Fax Number | 2538406733 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | LLC MANAGE |
|---|---|
| Authorized Official Name | Scillia M Carole |
| Telephone Number | 8603476300 |
NPI Number Detail
| NPI Number | 1417959875 |
|---|---|
| Provider Enumeration Date | 2005-08-15 |
| Last Updated Date | 2011-05-19 |
Provider Mailing Address Detail
| Address | 400 29th Street Ne |
|---|---|
| City | Puyallup |
| State | Washington (WA) |
| Post Code | 983726774 |
| Phone Number | 2538404400 |
| Fax Number | 2538406733 |
Provider's Primary Taxonomy Detail
| Speciality | Skilled Nursing Facility |
|---|---|
| Taxonomy | 314000000X |
| Licence No | NH1257 |
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Definition: (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring serv |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 4112579 | WA | -- |
Post Comment/ Review Below
What is the unique identifier code issued to Revera (Delaware) Llc by the Centers for Medicare & Medicaid Services (CMS)?
The Revera (Delaware) Llc has been assigned the NPI (National Provider Identifier) 1417959875. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Could you share the physical location details of Revera (Delaware) Llc?
The Revera (Delaware) Llc is situated at 400 29Th Street Ne, in the city of Puyallup, state of WA, with the zip code 983726774.
What is Revera (Delaware) Llc's specialized field of practice, and what is the corresponding taxonomy classification code?
The Revera (Delaware) Llc's area of specialization is Skilled Nursing Facility, and the corresponding taxonomy code that categorizes this field of practice is 314000000X.
On what date did the Revera (Delaware) Llc receive its 1417959875 assignment from the Centers for Medicare & Medicaid Services?
The Revera (Delaware) Llc was assigned its 1417959875 by the Centers for Medicare & Medicaid Services on 2005-08-15.
When was the information regarding Revera (Delaware) Llc most recently updated?
The details pertaining to the Revera (Delaware) Llc, including its address, specialty, and other relevant information, were last refreshed on 2011-05-19.