Provider Demographics
NPI:1073682001
Name:KINDRED HOSPITALS EAST, LLC
Entity Type:Organization
Organization Name:KINDRED HOSPITALS EAST, LLC
Other - Org Name:KINDRED HOSPITAL AT HERITAGE VALLEY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ASSISTANT SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:MARILYN
Authorized Official - Middle Name:A
Authorized Official - Last Name:WEAVER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-596-7563
Mailing Address - Street 1:680 S 4TH ST
Mailing Address - Street 2:K-LIVE 5 REIMBURSEMENT
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202-2407
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:502-596-4134
Practice Address - Street 1:1000 DUTCH RIDGE RD
Practice Address - Street 2:FLOOR 2
Practice Address - City:BEAVER
Practice Address - State:PA
Practice Address - Zip Code:15009-9727
Practice Address - Country:US
Practice Address - Phone:724-773-8480
Practice Address - Fax:724-773-8210
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-06
Last Update Date:2016-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA13570101282E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282E00000XHospitalsLong Term Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA2091OtherBLUE CROSS
PA2594867Medicaid
PA=========OtherCIGNA
PA=========OtherHUMANA
PA2091OtherBLUE CROSS
PA=========OtherAETNA
PA=========OtherUNITED HEALTHCARE