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NPI Code Detail

MEDICARE: OLD NATIONAL LEASING CO., LLC

MEDICARE: OLD NATIONAL LEASING CO., 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 Facility

General Provider Information

NPI Number : 1790443596
Entity Type Code : Organization
Provider Name (Legal Business Name) : OLD NATIONAL LEASING CO., LLC
Provider Business Mailing Address
First Line : 10123 ALLIANCE RD
Second Line :
City : BLUE ASH
State : OH
Zip : 45242-4887
Country : US
Telephone Number : 513-530-1808
Fax Number :
Provider Business Practice Location Address
First Line : 4101 BALTIMORE NATIONAL PIKE
Second Line :
City : MOUNT AIRY
State : MD
Zip : 21771-4115
Country : US
Telephone Number : 301-829-0800
Fax Number :
Authorized Official
Title or Position : SECRETARY / TREASURER
Name : CHARLES STOLTZ
Credential :
Telephone Number : 513-530-1808
Provider Enumeration Date : 11/30/2021
Last Update Date : 04/30/2025

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Directions to “OLD NATIONAL LEASING CO., LLC ” Practice Location

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