MEDICARE: ROCKY TOP 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	:	1699531038
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROCKY TOP OPERATIONS LLC

Provider Business Mailing Address
First Line	:	1621 GALLERIA BLVD
Second Line	:
City	:	BRENTWOOD
State	:	TN
Zip	:	37027-2926
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	204 INDUSTRIAL PARK LN
Second Line	:
City	:	ROCKY TOP
State	:	TN
Zip	:	37769-2301
Country	:	US
Telephone Number	:	865-426-2147
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	ERAN RATNER
Credential	:
Telephone Number	:	516-368-8012

Provider Enumeration Date	:	02/23/2024
Last Update Date	:	02/23/2024

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Directions to “ROCKY TOP OPERATIONS LLC ” Practice Location

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