Bolivar Operator Llc

NPI 1316018286 - Skilled Nursing Facility - 314000000X

NPI Details
NPI 1316018286
Enumeration Date 11/13/2006
Last Updated 12/30/2014
Entity Type Healthcare Provider
Active Over 10 years ago
Authorized Information
Name STACEY PAUL STACEY
Position CHIEF FINANCIAL OFFICER
Phone (731) 658-4707
Fax (731) 658-4769
Practice Location
700 NUCKOLLS RD
BOLIVAR TN, 38008-1531, US
Phone (731) 658-4707
Fax (731) 658-4769
Business Location
7400 NEW LA GRANGE RD
SUITE #100
LOUISVILLE KY, 40222-4870, US
Phone (502) 429-8062
Fax (502) 429-0650
Toxanomy
Taxonomy Code 314000000X
License State Tennessee
License Number 171
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According to our database, Bolivar Operator Llc NPI is 1316018286, taxonomy code is 314000000X and license number is 171, license state is located at Tennessee. Bolivar Operator Llc physically located at 700 Nuckolls Rd, Bolivar TN, 38008-1531. NPI Number 1033115704 has the healthcare provider type.

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1316018286 NPI number is provided on an as is basis without warranty of any kind. 1316018286 is maintained by the National Plan & Provider Enumeration System. The contents of Bolivar Operator Llc are for informational purposes only.