1447329461 NPI number — KINDRED HOSPITALS EAST, LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447329461 NPI number — KINDRED HOSPITALS EAST, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
KINDRED HOSPITALS EAST, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
KINDRED HOSPITAL - WYOMING VALLEY
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1447329461
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/10/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
680 S 4TH ST
Provider Second Line Business Mailing Address:
K-LIVE 5 REIMBURSEMENT
Provider Business Mailing Address City Name:
LOUISVILLE
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
40202-2407
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
502-596-7300
Provider Business Mailing Address Fax Number:
502-596-4134

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
575 N RIVER ST
Provider Second Line Business Practice Location Address:
SEVENTH FLOOR
Provider Business Practice Location Address City Name:
WILKES BARRE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18764-0999
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-552-7620
Provider Business Practice Location Address Fax Number:
570-552-7622
Provider Enumeration Date:
11/06/2006

Additional Information

Authorized Official

Authorized Official Last Name:
ROTHGERBER
Authorized Official First Name:
ARTHUR
Authorized Official Middle Name:
L.
Authorized Official Title or Position:
SR. VICE PRESIDENT OF REIMBURSEMENT
Authorized Official Telephone Number:
502-596-7300

Provider Taxonomy Codes

  • Taxonomy code: 282E00000X , with the licence number:  23450101 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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