Provider Demographics
NPI:1881772713
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:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOHNETTA
Authorized Official - Middle Name:
Authorized Official - Last Name:TRAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-596-6063
Mailing Address - Street 1:2401 S SIDE BLVD
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27406-3311
Mailing Address - Country:US
Mailing Address - Phone:336-271-2800
Mailing Address - Fax:336-271-2734
Practice Address - Street 1:2401 S SIDE BLVD
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27406-3311
Practice Address - Country:US
Practice Address - Phone:336-271-2800
Practice Address - Fax:336-271-2734
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2025-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCH-0073282E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282E00000XHospitalsLong Term Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3402012OtherHEALTH NET
NC00300OtherBLUE CROSS
NC3402012Medicaid
NC3402012Medicaid
NC=========OtherUNITED HEALTHCARE
NC=========OtherSECURE HORIZONS
NC=========OtherGREAT WEST
NC=========OtherHUMANA
NC00300OtherBLUE CROSS
NC3402012OtherHEALTH NET
NC3402012Medicaid