MEDICARE: 3G OPERATING COMPANY 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	2772	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1699773283
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	3G OPERATING COMPANY LLC

Provider Business Mailing Address
First Line	:	1919 BISHOP RD
Second Line	:
City	:	WICKLIFFE
State	:	OH
Zip	:	44092-2518
Country	:	US
Telephone Number	:	440-944-9400
Fax Number	:	330-944-2491

Provider Business Practice Location Address
First Line	:	1919 BISHOP RD
Second Line	:
City	:	WICKLIFFE
State	:	OH
Zip	:	44092-2518
Country	:	US
Telephone Number	:	440-944-9400
Fax Number	:	330-944-2491

Authorized Official
Title or Position	:	CFO
Name	:	MR. BARRY STUMP
Credential	:
Telephone Number	:	216-898-8399

Provider Enumeration Date	:	07/08/2005
Last Update Date	:	09/27/2022

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Directions to “3G OPERATING COMPANY LLC ” Practice Location

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