Healthcare Provider Details

I. General information

NPI: 1740328269
Provider Name (Legal Business Name): GS OPERATOR LP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2007
Last Update Date: 12/30/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7800 BUSTLETON AVE
PHILADELPHIA PA
19152-3812
US

IV. Provider business mailing address

7400 NEW LA GRANGE RD SUITE 100
LOUISVILLE KY
40222-4870
US

V. Phone/Fax

Practice location:
  • Phone: 215-722-2300
  • Fax: 215-728-7213
Mailing address:
  • Phone: 502-429-8062
  • Fax: 502-429-0650

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number210102
License Number StatePA

VIII. Authorized Official

Name: MR. STACEY PAUL ROGERS
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 502-429-8062