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1543 Country Club Road Manor Operations LLC

Skilled Nursing Facility in Fairmont, WV · enumerated 2008 · authorized official Michael Berg, Secretary.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1396981064

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Registry record

Entity type Organization (Type 2)
Legal business name 1543 Country Club Road Manor Operations LLC
Other name <Unavail>
Practice address 1543 Country Club Rd, Fairmont, WV, 26554
Phone (304) 363-2273
Enumeration date Dec 30, 2008
Last updated in NPPES Jul 9, 2025

Taxonomy & classification

314000000X Skilled Nursing Facility Nursing & Custodial Care Facilities · License 59 (WV) Primary

Authorized official

Name Michael Berg
Title Secretary
Phone (610) 444-6350

Other identifiers

Identifier Type State Issuer
3810013993 Medicaid WV -

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

What is a Type 2 NPI?
A Type 2 NPI identifies an organization (group practice, hospital, pharmacy, lab), while Type 1 NPIs identify individual providers. Organizations bill under their Type 2 NPI.
What type of organization is 1543 Country Club Road Manor Operations LLC?
1543 Country Club Road Manor Operations LLC is registered in NPPES as a Skilled Nursing Facility (its primary provider taxonomy).

Providers at this address

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2025-07-09.