Healthcare Provider Details

I. General information

NPI: 1174297063
Provider Name (Legal Business Name): AMHERST SNF OPERATIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2021
Last Update Date: 11/05/2021
Certification Date: 11/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

173 BROCKMAN PARK DR
AMHERST VA
24521-2583
US

IV. Provider business mailing address

1007 BROADWAY
WOODMERE NY
11598-1246
US

V. Phone/Fax

Practice location:
  • Phone: 434-946-2850
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: JOSEPH LIEBERMAN
Title or Position: DIRECTOR OF FINANCIAL OPERATIONS
Credential:
Phone: 516-855-5504