Healthcare Provider Details

I. General information

NPI: 1366214520
Provider Name (Legal Business Name): 4R0, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2023
Last Update Date: 10/23/2023
Certification Date: 10/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

540 COAL VALLEY RD
JEFFERSON HILLS PA
15025-3704
US

IV. Provider business mailing address

214 BELSAR RD
ELIZABETH PA
15037-2506
US

V. Phone/Fax

Practice location:
  • Phone: 412-466-1125
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DAVID FERRARO
Title or Position: MEMBER
Credential:
Phone: 412-890-8232