Provider Demographics
NPI:1194993238
Name:MARGARETVILLE NURSING HOME INC
Entity type:Organization
Organization Name:MARGARETVILLE NURSING HOME INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:BAKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-493-2846
Mailing Address - Street 1:42158 STATE HIGHWAY 28
Mailing Address - Street 2:
Mailing Address - City:MARGARETVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12455-2826
Mailing Address - Country:US
Mailing Address - Phone:845-943-6023
Mailing Address - Fax:845-943-6077
Practice Address - Street 1:42158 STATE HIGHWAY 28
Practice Address - Street 2:
Practice Address - City:MARGARETVILLE
Practice Address - State:NY
Practice Address - Zip Code:12455-2826
Practice Address - Country:US
Practice Address - Phone:845-943-6023
Practice Address - Fax:845-943-6077
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-12
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1226300N314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01481956Medicaid
NY335339001Medicare Oscar/Certification