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NPI Code Detail

MEDICARE: STANFORD CARE AND REHAB, LLC

MEDICARE: STANFORD CARE AND REHAB, 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 : 1174167514
Entity Type Code : Organization
Provider Name (Legal Business Name) : STANFORD CARE AND REHAB, LLC
Provider Business Mailing Address
First Line : 1050 CHINOE RD STE 350
Second Line :
City : LEXINGTON
State : KY
Zip : 40502-6571
Country : US
Telephone Number : 859-255-0075
Fax Number : 859-281-5150
Provider Business Practice Location Address
First Line : 105 HARMON HTS
Second Line :
City : STANFORD
State : KY
Zip : 40484-1111
Country : US
Telephone Number : 606-365-2141
Fax Number : 606-393-0890
Authorized Official
Title or Position : AR BILLING MANAGER
Name : BRENDA CAMPBELL
Credential :
Telephone Number : 859-255-0075
Provider Enumeration Date : 10/29/2019
Last Update Date : 10/29/2019

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