# ROLLINS BEDFORD CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Russellville Health Care Manor
- **Organization subpart:** No

## Provider details

- **NPI number:** 1629296306
- **Authorized official:** MR. RONALD M WEHTJE (VP CFO)
- **Authorized official phone:** (407) 975-3010

## Contact information

- **Practice address:** 683 E 3RD ST, RUSSELLVILLE, KY 42276-1872
- **Practice address phone:** (270) 726-9049
- **Practice address fax:** (270) 726-8706
- **Mailing address:** 602 COURTLAND ST, SUITE 200, ORLANDO, FL 32804-1360
- **Mailing address phone:** (407) 975-3000
- **Mailing address fax:** (407) 975-3090

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 313M00000X | Nursing Facility/Intermediate Care Facility | 100299 | KY | Yes |

## Other

- **Enumeration date:** 04/20/2007
- **Last updated:** 04/04/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 12503736 | — | KY |
| 05 | — | 90003948 | — | KY |