MEDICARE: LUZERNE REHABILITATION & NURSING 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	:	1508358292
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LUZERNE REHABILITATION & NURSING LLC

Provider Business Mailing Address
First Line	:	463 N HUNTER HWY
Second Line	:
City	:	DRUMS
State	:	PA
Zip	:	18222-2129
Country	:	US
Telephone Number	:	570-788-4175
Fax Number	:	570-788-4777

Provider Business Practice Location Address
First Line	:	463 N HUNTER HWY
Second Line	:
City	:	DRUMS
State	:	PA
Zip	:	18222-2129
Country	:	US
Telephone Number	:	570-788-4175
Fax Number	:	570-788-4777

Authorized Official
Title or Position	:	MEMBER
Name	:	JONATHAN STRAUSS
Credential	:
Telephone Number	:	201-214-8889

Provider Enumeration Date	:	05/30/2018
Last Update Date	:	05/30/2018

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