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NPI Code Detail

MEDICARE: RIDGEVIEW OPERATIONS LLC

MEDICARE: RIDGEVIEW OPERATIONS LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1314000000XSkilled Nursing Facility

General Provider Information

NPI Number : 1124484241
Entity Type Code : Organization
Provider Name (Legal Business Name) : RIDGEVIEW OPERATIONS LLC
Provider Business Mailing Address
First Line : 200 PENNSYLVANIA AVE
Second Line :
City : SHENANDOAH
State : PA
Zip : 17976-1332
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 200 PENNSYLVANIA AVE
Second Line :
City : SHENANDOAH
State : PA
Zip : 17976-1332
Country : US
Telephone Number : 570-462-1921
Fax Number :
Authorized Official
Title or Position : MEMBER
Name : EPHRAM M LAHASKY
Credential :
Telephone Number : 646-772-3668
Provider Enumeration Date : 01/05/2016
Last Update Date : 02/10/2016

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