MEDICARE: PLEASANT RIDGE CARE CENTER, INC.

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	NH-016880-NH	OH

General Provider Information

NPI Number	:	1831426733
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PLEASANT RIDGE CARE CENTER, INC.

Provider Business Mailing Address
First Line	:	5501 VERULAM AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45213-2417
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5501 VERULAM AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45213-2417
Country	:	US
Telephone Number	:	513-631-1310
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. HAROLD SOSNA
Credential	:
Telephone Number	:	513-561-4105

Provider Enumeration Date	:	11/13/2009
Last Update Date	:	08/14/2020

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