Healthcare Provider Details

I. General information

NPI: 1780940338
Provider Name (Legal Business Name): KINDRED HEALTHCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/09/2012
Last Update Date: 04/09/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1717 SKYLINE DR
PITTSBURGH PA
15227-1744
US

IV. Provider business mailing address

304 JOANN DRIVE
WEST MIFFLIN PA
15122
US

V. Phone/Fax

Practice location:
  • Phone: 412-881-6168
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberOP007204
License Number StatePA

VIII. Authorized Official

Name: NICOLE KOROTKO
Title or Position: REHAB MANAGER
Credential:
Phone: 412-881-6168