MEDICARE: ALEXANDRIA SNF 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	:	1346951761
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALEXANDRIA SNF OPERATIONS LLC

Provider Business Mailing Address
First Line	:	1510 COLLINGWOOD RD
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22308-1605
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1510 COLLINGWOOD RD
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22308-1605
Country	:	US
Telephone Number	:	703-765-6107
Fax Number	:

Authorized Official
Title or Position	:	VICE PRESIDENT OF PROCUREMENT
Name	:	JOSEPH LIEBERMAN
Credential	:
Telephone Number	:	646-275-4510

Provider Enumeration Date	:	12/06/2022
Last Update Date	:	12/06/2022

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