MEDICARE: NHRC ACQUISITION 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	:	1538533278
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NHRC ACQUISITION LLC

Provider Business Mailing Address
First Line	:	64 HAGER ST
Second Line	:
City	:	BUFFALO
State	:	NY
Zip	:	14208-1327
Country	:	US
Telephone Number	:	716-886-4377
Fax Number	:

Provider Business Practice Location Address
First Line	:	64 HAGER ST
Second Line	:
City	:	BUFFALO
State	:	NY
Zip	:	14208-1327
Country	:	US
Telephone Number	:	716-886-4377
Fax Number	:

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	JEFFREY GOLDSTEIN
Credential	:
Telephone Number	:	718-927-6300

Provider Enumeration Date	:	11/18/2015
Last Update Date	:	11/18/2015

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