Healthcare Provider Details

I. General information

NPI: 1942792858
Provider Name (Legal Business Name): SBK4 MANAGEMENT, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/06/2018
Last Update Date: 06/06/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2410 PERRY HWY, UNIT 410-F
ZELIENOPLE PA
16063
US

IV. Provider business mailing address

44 TIMBERHILL DR
SEWICKLEY PA
15143-8911
US

V. Phone/Fax

Practice location:
  • Phone: 724-452-6691
  • Fax:
Mailing address:
  • Phone: 412-551-8786
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. BRENDAN KEN NY
Title or Position: OWNER
Credential:
Phone: 412-551-8786