Masonicare Health Center
Skilled Nursing Facility in Wallingford, CT. Organization (NPI-2).
NPI number1043690100
StatusActive
Last updated in NPPESJun 4, 2015
Details
- NPI
- 1043690100
- Entity type
- Organization (NPI-2)
- Legal business name
- Masonicare Health Center
- Organization subpart
- Yes
- Enumeration date
- Jun 4, 2015
- Last updated
- Jun 4, 2015
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 314000000X | Skilled Nursing Facility | 10225 | CT | Yes |
Practice location
22 Masonic AveWallingford, CT 06492-3048
Phone 203-679-5959
Mailing address
22 Masonic AveWallingford, CT 06492-3048
Authorized official
Audrey Webber
Pt
2036795959
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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