Provider Demographics
NPI:1528667581
Name:WINTERFEST MEDICAL SERVICES CORPORATION
Entity type:Organization
Organization Name:WINTERFEST MEDICAL SERVICES CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANET
Authorized Official - Middle Name:
Authorized Official - Last Name:AGUSTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-284-4129
Mailing Address - Street 1:8758 WINTERFEST WAY
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95624-1295
Mailing Address - Country:US
Mailing Address - Phone:916-284-4129
Mailing Address - Fax:916-244-7162
Practice Address - Street 1:8758 WINTERFEST WAY
Practice Address - Street 2:
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95624-1295
Practice Address - Country:US
Practice Address - Phone:916-284-4129
Practice Address - Fax:916-244-7162
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-21
Last Update Date:2020-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility