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NPI Code Detail

MEDICARE: LP LEXINGTON TANBARK ROAD, LLC

MEDICARE: LP LEXINGTON TANBARK ROAD, 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

General Provider Information

NPI Number : 1407226319
Entity Type Code : Organization
Provider Name (Legal Business Name) : LP LEXINGTON TANBARK ROAD, LLC
Provider Business Mailing Address
First Line : 12201 BLUEGRASS PKWY
Second Line :
City : LOUISVILLE
State : KY
Zip : 40299-2361
Country : US
Telephone Number : 502-568-7800
Fax Number :
Provider Business Practice Location Address
First Line : 1121 TANBARK RD
Second Line :
City : LEXINGTON
State : KY
Zip : 40515-1826
Country : US
Telephone Number : 859-273-7377
Fax Number :
Authorized Official
Title or Position : CFO
Name : JOHN HARRISON
Credential :
Telephone Number : 502-568-7800
Provider Enumeration Date : 10/05/2015
Last Update Date : 04/04/2023

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Directions to “LP LEXINGTON TANBARK ROAD, LLC ” Practice Location

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