Healthcare Provider Details

I. General information

NPI: 1326222506
Provider Name (Legal Business Name): SADDLE SHOP ROAD OPERATIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/24/2007
Last Update Date: 07/20/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

SADDLE SHOP ROAD
HILLTOP WV
25855
US

IV. Provider business mailing address

101 E STATE ST
KENNETT SQUARE PA
19348-3109
US

V. Phone/Fax

Practice location:
  • Phone: 304-469-2966
  • Fax: 304-469-6280
Mailing address:
  • Phone: 610-925-4436
  • Fax: 610-925-4351

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number72
License Number StateWV

VIII. Authorized Official

Name: JANE DROPESKEY
Title or Position: CORPORATE MANAGER
Credential:
Phone: 610-925-4231