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General NPI Number Information
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NPI Number | 1407501661
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Entity Type | Organization
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Legal Business Name | SHOR CO, LLC
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Dates
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Enumeration Date | 02/16/2022
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Last Update Date | 02/16/2022
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Provider Practice Location Address
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Address Line | 1006 33RD ST
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City | VERO BEACH
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State | FL
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Zip | 32960-6910
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Country | US
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Telephone | 772-567-5248
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Fax |
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Provider Business Mailing Address
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Address Line | 200 CLEARWATER LARGO RD S
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City | LARGO
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State | FL
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Zip | 33770-3235
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Country | US
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Telephone | 904-422-5231
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | KEVIN ROCKEFELLER
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Credential |
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Telephone | 904-422-5231
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State |
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