Provider Demographics
NPI:1952883423
Name:ROSCOE REGIONAL HEALTHCARE LLC
Entity Type:Organization
Organization Name:ROSCOE REGIONAL HEALTHCARE LLC
Other - Org Name:ROSCOE REGIONAL REHABILITATION AND NURSING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AUTHORIZED SIGNATORY
Authorized Official - Prefix:
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:FARBENBLUM
Authorized Official - Suffix:
Authorized Official - Credentials:ESQ
Authorized Official - Phone:516-350-5551
Mailing Address - Street 1:420 ROCKLAND RD
Mailing Address - Street 2:
Mailing Address - City:ROSCOE
Mailing Address - State:NY
Mailing Address - Zip Code:12776-6450
Mailing Address - Country:US
Mailing Address - Phone:607-498-4121
Mailing Address - Fax:
Practice Address - Street 1:420 ROCKLAND RD
Practice Address - Street 2:
Practice Address - City:ROSCOE
Practice Address - State:NY
Practice Address - Zip Code:12776-6450
Practice Address - Country:US
Practice Address - Phone:607-498-4121
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-31
Last Update Date:2018-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility