National Provider Identifier
Blossom South, LLC
Blossom South, LLC is listed in the NPPES registry with a primary specialty of Skilled Nursing Facility in Rochester, NY and a listed phone number of (585) 442-0450.
Profile Overview
- NPI
- 1750444246
- Provider Type
- Organization
- Primary Specialty
- Skilled Nursing Facility
- Enumeration Date
- December 18, 2006
- Last Updated
- July 19, 2007
Practice Location
- 1175 Monroe Ave
- Rochester, NY 14620-1613
Phone: (585) 442-0450
Specialties
- Skilled Nursing Facility (314000000X)
Full Record
- NPI
- 1750444246
- Entity Type
- Organization
- EIN
- <UNAVAIL>
- Organization Name
- Blossom South, LLC
- Other Organization Name
- <Unavail>
- Provider Other Organization Name Type Code
- 6
- Mailing Street Address
- 1175 Monroe Ave
- Mailing City
- Rochester
- Mailing State
- NY
- Mailing ZIP Code
- 14620-1613
- Mailing Country
- US
- Mailing Phone
- (585) 442-0450
- Mailing Fax
- (585) 442-2855
- Practice Street Address
- 1175 Monroe Ave
- Practice City
- Rochester
- Practice State
- NY
- Practice ZIP Code
- 14620-1613
- Practice Country
- US
- Practice Phone
- (585) 442-0450
- Practice Fax
- (585) 442-2855
- Enumeration Date
- December 18, 2006
- Last Updated
- July 19, 2007
- Authorized Official Last Name
- Wood
- Authorized Official First Name
- Gerald
- Authorized Official Middle Name
- J
- Authorized Official Title
- Operator
- Authorized Official Phone
- (516) 679-1500
- Organization Subpart
- No
- Taxonomies
- Skilled Nursing Facility (314000000X)
- Other Identifiers
- 00355573 (NY), 183542CI (NY, Preferred Care)