Provider Demographics
NPI:1295804219
Name:KINDRED HOSPITALS EAST, LLC
Entity type:Organization
Organization Name:KINDRED HOSPITALS EAST, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
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 1:7777 STEUBENVILLE PIKE
Practice Address - Street 2:
Practice Address - City:OAKDALE
Practice Address - State:PA
Practice Address - Zip Code:15071-3409
Practice Address - Country:US
Practice Address - Phone:412-494-5500
Practice Address - Fax:412-494-5511
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
PA490601282E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282E00000XHospitalsLong Term Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1088OtherBLUE CROSS
PA1773350Medicaid
PA=========OtherAETNA
PA=========OtherUNITED HEALTHCARE
PA1773350Medicaid
PA=========OtherCIGNA
PA1773350Medicaid