Healthcare Provider Details

I. General information

NPI: 1659481943
Provider Name (Legal Business Name): KHOI NEW LIMITED PARTNERSHIP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 07/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

43 STARR FARM RD
BURLINGTON VT
05401
US

IV. Provider business mailing address

680 S. 4TH STREET KH-2 REIMBURSEMENT
LOUISVILLE KY
40202-2407
US

V. Phone/Fax

Practice location:
  • Phone: 802-863-6384
  • Fax: 802-865-4516
Mailing address:
  • Phone: 502-596-7563
  • Fax: 502-596-4134

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number27-0000369
License Number StateVT

VIII. Authorized Official

Name: MARILYN WEAVER
Title or Position: ASSISTANT SECRETARY
Credential:
Phone: 502-596-7563