Healthcare Provider Details

I. General information

NPI: 1811992472
Provider Name (Legal Business Name): ROCKLEDGE NH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2005
Last Update Date: 06/03/2024
Certification Date: 06/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

587 BARTON BLVD
ROCKLEDGE FL
32955-3145
US

IV. Provider business mailing address

587 BARTON BLVD
ROCKLEDGE FL
32955-3145
US

V. Phone/Fax

Practice location:
  • Phone: 321-632-6300
  • Fax: 321-631-5428
Mailing address:
  • Phone: 321-632-6300
  • Fax: 321-631-5428

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberSNF15340961
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: MOSHE SCHEINER
Title or Position: CEO
Credential:
Phone: 813-557-6200