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NPI Code Detail

MEDICARE: CANTERBURY OPERATOR LLC

MEDICARE: CANTERBURY OPERATOR 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 : 1811546955
Entity Type Code : Organization
Provider Name (Legal Business Name) : CANTERBURY OPERATOR LLC
Provider Business Mailing Address
First Line : 1608 ROUTE 88
Second Line :
City : BRICK
State : NJ
Zip : 08724-3009
Country : US
Telephone Number : 732-903-1958
Fax Number :
Provider Business Practice Location Address
First Line : 1776 CAMBRIDGE DR
Second Line :
City : RICHMOND
State : VA
Zip : 23238-3203
Country : US
Telephone Number : 804-740-6174
Fax Number :
Authorized Official
Title or Position : PRINCIPLE
Name : YITZCHOK ROKOWSKY
Credential :
Telephone Number : 732-903-1958
Provider Enumeration Date : 09/11/2019
Last Update Date : 04/04/2024

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Directions to “CANTERBURY OPERATOR LLC ” Practice Location

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