| NPI | 1174575625 |
|---|---|
| Doing Business As | WEDGEWOOD NURSING HOME |
| Entity Type | Organization |
| Authorized Contact | PETER J LICARI President Of General Partner 215-441-7700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: TX 115374) |
| Additional Taxonomies | 332BN1400X Durable Medical Equipment & Medical Supplies, Nursing Facility Supplies (Licence: TX 115374) |
| 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition (Licence: TX 115374) | |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2007-10-30 |