Healthcare Provider Details

I. General information

NPI: 1639410806
Provider Name (Legal Business Name): COSHOCTON OPCO, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/12/2013
Last Update Date: 02/17/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 S WHITEWOMAN ST
COSHOCTON OH
43812-1068
US

IV. Provider business mailing address

6 CADILLAC DR SUITE 310
BRENTWOOD TN
37027-5080
US

V. Phone/Fax

Practice location:
  • Phone: 740-622-1220
  • Fax: 740-622-6384
Mailing address:
  • Phone: 615-250-7100
  • Fax: 615-252-7102

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: WILLIAM D. ORAND
Title or Position: CEO
Credential:
Phone: 615-250-7100