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NPI Code Detail

MEDICARE: COPPELL SNF OPERATIONS LLC

MEDICARE: COPPELL SNF 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
1314000000XSkilled Nursing Facility

General Provider Information

NPI Number : 1891118238
Entity Type Code : Organization
Provider Name (Legal Business Name) : COPPELL SNF OPERATIONS LLC
Provider Business Mailing Address
First Line : 1500 WATERS RIDGE DR
Second Line :
City : LEWISVILLE
State : TX
Zip : 75057-6011
Country : US
Telephone Number : 972-899-4401
Fax Number : 972-899-4806
Provider Business Practice Location Address
First Line : 1410 E SANDY LAKE RD
Second Line :
City : COPPELL
State : TX
Zip : 75019-3119
Country : US
Telephone Number : 972-304-4444
Fax Number : 972-462-6605
Authorized Official
Title or Position : AUTHORIZED OFFICER
Name : PAULA PIERCE
Credential :
Telephone Number : 972-899-4401
Provider Enumeration Date : 01/21/2014
Last Update Date : 01/21/2014

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Directions to “COPPELL SNF OPERATIONS LLC ” Practice Location

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