Organization
BEDROCK HC AT GREEN MEADOWS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH D NICHOLS (MANAGER)
(813) 777-4663
Entity
Organization
Contact information
Practice address
310 BOXWOOD RUN, MOUNT WASHINGTON, KY 40047-7143
(502) 955-7600
(502) 995-7395
Mailing address
310 BOXWOOD RUN, MOUNT WASHINGTON, KY 40047-7143
(502) 955-7600
(502) 995-7395
Taxonomy
Speciality
Code
Description
License number
State
261QH0700X
Hearing and Speech Clinic/Center
—
—
261QP2000X
Physical Therapy Clinic/Center
—
—
261QX0100X
Occupational Medicine Clinic/Center
—
—
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
02/14/2019
Last updated
07/24/2019
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