| Cardinal Virtues Long Term Care | |
|
810 W 2nd St Unit A Waverly OH 45690-9433 | |
| (740) 352-7733 | |
| Not Available |
| Full Name | Cardinal Virtues Long Term Care |
|---|---|
| Speciality | Family Medicine |
| Location | 810 W 2nd St Unit A, Waverly, Ohio |
| Authorized Official Name and Position | Sean D Stiltner (OWNER) |
| Authorized Official Contact | 7403527733 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cardinal Virtues Long Term Care Po Box 429 Piketon OH 45661-0429 Ph: (740) 352-7733 | Cardinal Virtues Long Term Care 810 W 2nd St Unit A Waverly OH 45690-9433 Ph: (740) 352-7733 |
| NPI Number | 1164283750 |
|---|---|
| Provider Enumeration Date | 01/19/2024 |
| Last Update Date | 05/12/2026 |
| Medicare PECOS PAC ID | 9133568868 |
|---|---|
| Medicare Enrollment ID | O20240415001922 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164283750 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Sean Duane Stiltner |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821156472 PECOS PAC ID: 0143220889 Enrollment ID: I20070103000428 |
| Provider Name | Ray Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184277865 PECOS PAC ID: 2668701251 Enrollment ID: I20190906002085 |
| Provider Name | Brandon Lasseter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861104218 PECOS PAC ID: 8527430032 Enrollment ID: I20230209002587 |
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