MEDICARE: BAIRD NURSING HOME,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	2701357N	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	125008CI	OTHER	NY	PREFERRED CARE
3	P015005978	OTHER	NY	EXCELLUS BLUE CROSS

General Provider Information

NPI Number	:	1053313825
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BAIRD NURSING HOME,LLC

Provider Business Mailing Address
First Line	:	2150 SAINT PAUL ST
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14621-1415
Country	:	US
Telephone Number	:	585-342-5540
Fax Number	:	585-342-3539

Provider Business Practice Location Address
First Line	:	2150 SAINT PAUL ST
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14621-1415
Country	:	US
Telephone Number	:	585-342-5540
Fax Number	:	585-342-3539

Authorized Official
Title or Position	:	OWNER/ADMINISTRATOR
Name	:	MR. STEPHEN T HEARD
Credential	:
Telephone Number	:	585-342-5540

Provider Enumeration Date	:	08/11/2005
Last Update Date	:	02/03/2015

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