MEDICARE: GOLDEN HILL NURSING AND REHAB LP

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	850302	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0600	OTHER		HIGHMARK BLUE CROSS
2	25-1150339	OTHER		HOP ADMINISTRATOR - PSERS
3	215867	OTHER		UPMC HEALTH PLAN
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	76398	OTHER		ADVANTRA
6	1502705	OTHER	PA	GATEWAY HEALTH PLAN

General Provider Information

NPI Number	:	1679575989
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GOLDEN HILL NURSING AND REHAB LP

Provider Business Mailing Address
First Line	:	520 FRIENDSHIP ST
Second Line	:
City	:	NEW CASTLE
State	:	PA
Zip	:	16101-4596
Country	:	US
Telephone Number	:	724-654-7791
Fax Number	:	724-654-7891

Provider Business Practice Location Address
First Line	:	520 FRIENDSHIP ST
Second Line	:
City	:	NEW CASTLE
State	:	PA
Zip	:	16101-4596
Country	:	US
Telephone Number	:	724-654-7791
Fax Number	:	724-654-7891

Authorized Official
Title or Position	:	CEO
Name	:	MR. STEVEN D TACK
Credential	:
Telephone Number	:	724-431-0770

Provider Enumeration Date	:	06/01/2005
Last Update Date	:	08/14/2014

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Directions to “GOLDEN HILL NURSING AND REHAB LP ” Practice Location

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