Healthcare Provider Details

I. General information

NPI: 1306918040
Provider Name (Legal Business Name): KINDRED HOSPITALS EAST, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2006
Last Update Date: 07/16/2025
Certification Date: 07/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6129 PALMETTO ST
PHILADELPHIA PA
19111-5729
US

IV. Provider business mailing address

680 S 4TH ST
LOUISVILLE KY
40202-2407
US

V. Phone/Fax

Practice location:
  • Phone: 215-722-8555
  • Fax: 215-725-8998
Mailing address:
  • Phone: 502-596-6063
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282E00000X
TaxonomyLong Term Care Hospital
License Number120101
License Number StatePA

VIII. Authorized Official

Name: JOHNETTA TRAYLOR
Title or Position: DIRECTOR LICENSE AND CERTIFICATION
Credential:
Phone: 502-596-6063