# BEDROCK HC AT GREEN MEADOWS LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1730645771
- **Authorized official:** KENNETH D NICHOLS (MANAGER)
- **Authorized official phone:** (813) 777-4663

## Contact information

- **Practice address:** 310 BOXWOOD RUN, MOUNT WASHINGTON, KY 40047-7143
- **Practice address phone:** (502) 955-7600
- **Practice address fax:** (502) 995-7395
- **Mailing address:** 310 BOXWOOD RUN, MOUNT WASHINGTON, KY 40047-7143
- **Mailing address phone:** (502) 955-7600
- **Mailing address fax:** (502) 995-7395

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QH0700X | Hearing and Speech Clinic/Center | — | — | — |
| 261QP2000X | Physical Therapy Clinic/Center | — | — | — |
| 261QX0100X | Occupational Medicine Clinic/Center | — | — | — |
| 314000000X | Skilled Nursing Facility | — | — | Yes |

## Other

- **Enumeration date:** 02/14/2019
- **Last updated:** 07/24/2019