MEDICARE: PLYMOUTH SNF 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
1	314000000X	Skilled Nursing Facility

General Provider Information

NPI Number	:	1659220812
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PLYMOUTH SNF OPERATIONS, LLC

Provider Business Mailing Address
First Line	:	10913 S RIVER FRONT PKWY STE 290
Second Line	:
City	:	SOUTH JORDAN
State	:	UT
Zip	:	84095-3507
Country	:	US
Telephone Number	:	508-746-4343
Fax Number	:

Provider Business Practice Location Address
First Line	:	123 SOUTH ST
Second Line	:
City	:	PLYMOUTH
State	:	MA
Zip	:	02360-2945
Country	:	US
Telephone Number	:	508-746-4343
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	BRIAN RAMOS
Credential	:
Telephone Number	:	508-746-4343

Provider Enumeration Date	:	01/22/2026
Last Update Date	:	01/22/2026

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