Provider Demographics
NPI:1073776241
Name:KINDRED NURSING CENTERS EAST LLC
Entity Type:Organization
Organization Name:KINDRED NURSING CENTERS EAST LLC
Other - Org Name:PICKERINGTON NURSING & REHABILITATION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SR VICE PRESIDENT OF REIMBURSEMENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:L
Authorized Official - Last Name:ROTHGERBER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-596-7300
Mailing Address - Street 1:1300 HILL RD N
Mailing Address - Street 2:
Mailing Address - City:PICKERINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43147-8986
Mailing Address - Country:US
Mailing Address - Phone:614-863-1858
Mailing Address - Fax:614-751-2032
Practice Address - Street 1:1300 HILL RD N
Practice Address - Street 2:
Practice Address - City:PICKERINGTON
Practice Address - State:OH
Practice Address - Zip Code:43147-8986
Practice Address - Country:US
Practice Address - Phone:614-863-1858
Practice Address - Fax:614-751-2032
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KINDRED HEALTHCARE INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-07-08
Last Update Date:2008-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH6374314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2540316 (FOR OXYGEN)Medicaid