Provider Demographics
NPI:1023004751
Name:ROLLING FIELDS INC
Entity Type:Organization
Organization Name:ROLLING FIELDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT OF FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:BOSWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-338-9766
Mailing Address - Street 1:9108 STATE HWY 198
Mailing Address - Street 2:
Mailing Address - City:CONNEAUTVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16406-2646
Mailing Address - Country:US
Mailing Address - Phone:814-587-2012
Mailing Address - Fax:814-587-2483
Practice Address - Street 1:9108 STATE HWY 198
Practice Address - Street 2:
Practice Address - City:CONNEAUTVILLE
Practice Address - State:PA
Practice Address - Zip Code:16406-2646
Practice Address - Country:US
Practice Address - Phone:814-587-2012
Practice Address - Fax:814-587-2483
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-27
Last Update Date:2022-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA183302314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
472OtherHIGHMARK
PA1001344640003Medicaid
472OtherHIGHMARK