MEDICARE: SB OPERATING COMPANY 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
1	314000000X	Skilled Nursing Facility

General Provider Information

NPI Number	:	1326467960
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SB OPERATING COMPANY LLC

Provider Business Mailing Address
First Line	:	1561 COLD SPRING RD
Second Line	:
City	:	WILLIAMSTOWN
State	:	MA
Zip	:	01267-2743
Country	:	US
Telephone Number	:	413-458-8127
Fax Number	:

Provider Business Practice Location Address
First Line	:	1561 COLD SPRING RD
Second Line	:
City	:	WILLIAMSTOWN
State	:	MA
Zip	:	01267-2743
Country	:	US
Telephone Number	:	413-458-8127
Fax Number	:

Authorized Official
Title or Position	:	MEMBER
Name	:	MR. ALEXANDER M SHERMAN
Credential	:
Telephone Number	:	516-621-5400

Provider Enumeration Date	:	04/10/2014
Last Update Date	:	04/10/2014

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Directions to “SB OPERATING COMPANY LLC ” Practice Location

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