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NPI Code Detail

MEDICARE: 867 YORK ROAD OPERATIONS LLC

MEDICARE: 867 YORK ROAD 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
1314000000XSkilled Nursing Facility078502PA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1487836896
Entity Type Code : Organization
Provider Name (Legal Business Name) : 867 YORK ROAD OPERATIONS LLC
Provider Business Mailing Address
First Line : 101 E STATE ST
Second Line :
City : KENNETT SQUARE
State : PA
Zip : 19348-3109
Country : US
Telephone Number : 610-925-4436
Fax Number : 610-612-5327
Provider Business Practice Location Address
First Line : 867 YORK RD
Second Line :
City : GETTYSBURG
State : PA
Zip : 17325-7501
Country : US
Telephone Number : 717-337-3238
Fax Number :
Authorized Official
Title or Position : SECRETARY
Name : MICHAEL BERG
Credential :
Telephone Number : 610-444-6350
Provider Enumeration Date : 11/28/2007
Last Update Date : 06/23/2025

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