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NPI Code Detail

MEDICARE: METCALFE OPCO LLC

MEDICARE: METCALFE OPCO 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
1314000000XSkilled Nursing Facility

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1100470OTHERKYLICENSE

General Provider Information

NPI Number : 1285591230
Entity Type Code : Organization
Provider Name (Legal Business Name) : METCALFE OPCO LLC
Provider Business Mailing Address
First Line : 701 SKYLINE DR
Second Line :
City : EDMONTON
State : KY
Zip : 42129-8131
Country : US
Telephone Number : 270-432-2921
Fax Number : 270-432-2046
Provider Business Practice Location Address
First Line : 701 SKYLINE DR
Second Line :
City : EDMONTON
State : KY
Zip : 42129-8131
Country : US
Telephone Number : 270-432-2921
Fax Number : 270-432-2046
Authorized Official
Title or Position : MANAGING MEMBER
Name : MOSHE KELMAN
Credential :
Telephone Number : 270-432-2921
Provider Enumeration Date : 01/09/2026
Last Update Date : 01/09/2026

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Directions to “METCALFE OPCO LLC ” Practice Location

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