MEDICARE: RICHFIELD NURSING AND REHABILITATION 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	:	1497409858
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RICHFIELD NURSING AND REHABILITATION LLC

Provider Business Mailing Address
First Line	:	34 LORD AVE
Second Line	:
City	:	LAWRENCE
State	:	NY
Zip	:	11559-1324
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	631 MAIN ST
Second Line	:
City	:	RICHFIELD
State	:	PA
Zip	:	17086-8691
Country	:	US
Telephone Number	:	717-694-3434
Fax Number	:

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	AKIKO IKE
Credential	:
Telephone Number	:	646-580-8388

Provider Enumeration Date	:	02/04/2022
Last Update Date	:	02/04/2022

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