MEDICARE: LP BEDFORD 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	100506	KY

General Provider Information

NPI Number	:	1700077070
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LP BEDFORD LLC

Provider Business Mailing Address
First Line	:	12201 BLUEGRASS PKWY
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40299-2361
Country	:	US
Telephone Number	:	502-568-7800
Fax Number	:	502-568-7150

Provider Business Practice Location Address
First Line	:	50 SHEPHERD LN
Second Line	:
City	:	BEDFORD
State	:	KY
Zip	:	40006-8809
Country	:	US
Telephone Number	:	502-255-3244
Fax Number	:	502-255-7844

Authorized Official
Title or Position	:	CFO
Name	:	MR. JOHN HARRISON
Credential	:
Telephone Number	:	502-568-7800

Provider Enumeration Date	:	08/05/2007
Last Update Date	:	10/02/2010

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Directions to “LP BEDFORD LLC ” Practice Location

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