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NPI Code Detail

MEDICARE: BLOOMFIELD NURSING OPERATIONS LLC

MEDICARE: BLOOMFIELD NURSING 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 Facility1054NM

General Provider Information

NPI Number : 1598964223
Entity Type Code : Organization
Provider Name (Legal Business Name) : BLOOMFIELD NURSING OPERATIONS LLC
Provider Business Mailing Address
First Line : 306 W 7TH ST STE 415
Second Line :
City : FORT WORTH
State : TX
Zip : 76102-4905
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 803 HACIENDA LN
Second Line :
City : BLOOMFIELD
State : NM
Zip : 87413-5109
Country : US
Telephone Number : 505-632-1823
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : KENT HARRINGTON
Credential :
Telephone Number : 817-335-4111
Provider Enumeration Date : 07/12/2007
Last Update Date : 07/12/2007

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Directions to “BLOOMFIELD NURSING OPERATIONS LLC ” Practice Location

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