MEDICARE: NASH OPCO LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	310400000X	Assisted Living Facility
2	343900000X	Non-emergency Medical Transport (VAN)
3	311ZA0620X	Adult Care Home Facility

General Provider Information

NPI Number	:	1598232563
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NASH OPCO LLC

Provider Business Mailing Address
First Line	:	PO BOX 2568
Second Line	:
City	:	HICKORY
State	:	NC
Zip	:	28603-2568
Country	:	US
Telephone Number	:	828-322-5535
Fax Number	:

Provider Business Practice Location Address
First Line	:	1365 RIVER DR
Second Line	:
City	:	ROCKY MOUNT
State	:	NC
Zip	:	27804-4417
Country	:	US
Telephone Number	:	252-557-2740
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	MR. CHARLES E TREFZGER JR.
Credential	:
Telephone Number	:	828-322-5535

Provider Enumeration Date	:	10/29/2018
Last Update Date	:	05/05/2023

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Directions to “NASH OPCO LLC ” Practice Location

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