Healthcare Provider Details

I. General information

NPI: 1497407977
Provider Name (Legal Business Name): NEW PORT RICHEY OPCO, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/25/2022
Last Update Date: 01/25/2022
Certification Date: 01/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8417 OLD COUNTY ROAD 54
NEW PORT RICHEY FL
34653-6418
US

IV. Provider business mailing address

8417 OLD COUNTY ROAD 54
NEW PORT RICHEY FL
34653-6418
US

V. Phone/Fax

Practice location:
  • Phone: 727-376-1585
  • Fax: 727-372-7085
Mailing address:
  • Phone: 727-376-1585
  • Fax: 727-372-7085

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: MATHEW VARGHESE
Title or Position: MEMBER
Credential:
Phone: 917-817-3530