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NPI Code Detail

MEDICARE: STANFORD LEASING, LLC

MEDICARE: STANFORD LEASING, 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 Facility100290KY

General Provider Information

NPI Number : 1396295390
Entity Type Code : Organization
Provider Name (Legal Business Name) : STANFORD LEASING, LLC
Provider Business Mailing Address
First Line : 29225 CHAGRIN BLVD
Second Line : STE 230
City : CLEVELAND
State : OH
Zip : 44122-4645
Country : US
Telephone Number : 216-367-1214
Fax Number : 866-629-9730
Provider Business Practice Location Address
First Line : 105 HARMON HTS
Second Line :
City : STANFORD
State : KY
Zip : 40484-1111
Country : US
Telephone Number : 606-365-2141
Fax Number :
Authorized Official
Title or Position : MANAGER
Name : ELI M GUNZBURG
Credential :
Telephone Number : 440-658-1040
Provider Enumeration Date : 10/13/2016
Last Update Date : 10/13/2016

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