MEDICARE: ROBERTSON OPERATIONS, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	314000000X	Skilled Nursing Facility

General Provider Information

NPI Number	:	1023560661
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROBERTSON OPERATIONS, LLC

Provider Business Mailing Address
First Line	:	300 PROVIDER CT
Second Line	:
City	:	RICHMOND
State	:	KY
Zip	:	40475-8488
Country	:	US
Telephone Number	:	859-623-0898
Fax Number	:

Provider Business Practice Location Address
First Line	:	ROUTE 2 HWY 62
Second Line	:
City	:	MT. OLIVET
State	:	KY
Zip	:	41064
Country	:	US
Telephone Number	:	859-626-8106
Fax Number	:

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	BENJAMIN LANDA
Credential	:
Telephone Number	:	516-869-3700

Provider Enumeration Date	:	10/31/2016
Last Update Date	:	06/16/2017

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