30 West Avenue Operations LLC
NPI 1093973158ActiveOrganization· Skilled Nursing Facility· Wayne, PA
Skilled Nursing Facility in Wayne, Pennsylvania, registered in NPPES in May 2008. The authorized official on file is Michael T. Berg, Secretary. Enrolled in Medicare as part a provider - skilled nursing facility.
Overview
| NPI | 1093973158 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | May 27, 2008 |
| Last updated in NPPES | Oct 6, 2025 |
| Certified by provider | Oct 6, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Skilled Nursing Facility Primary | 314000000X | 750102 | PA |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part A Provider - Skilled Nursing Facility (PA) |
|---|
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