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NPI Code Detail

MEDICARE: ST. MATTHEWS CARE AND REHAB CENTER, LLC

MEDICARE: ST. MATTHEWS CARE AND REHAB CENTER, 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 : 1396389748
Entity Type Code : Organization
Provider Name (Legal Business Name) : ST. MATTHEWS CARE AND REHAB CENTER, 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 : 227 BROWNS LN
Second Line :
City : LOUISVILLE
State : KY
Zip : 40207-3215
Country : US
Telephone Number : 502-893-2595
Fax Number : 502-526-5960
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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