Healthcare Provider Details

I. General information

NPI: 1942576830
Provider Name (Legal Business Name): KINDRED HEALTHCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2012
Last Update Date: 03/26/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1717 SKYLINE DR
PITTSBURGH PA
15227-1744
US

IV. Provider business mailing address

205 WOODSIDE LN
VERONA PA
15147-3441
US

V. Phone/Fax

Practice location:
  • Phone: 412-881-6168
  • Fax:
Mailing address:
  • Phone: 412-795-1865
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberSL008682
License Number StatePA

VIII. Authorized Official

Name: MRS. NICOLE KOROTKO
Title or Position: SPEECH LANGUAGE PATHOLOGIST
Credential: MS CCC/SLP
Phone: 412-881-6168