Provider Demographics
NPI:1962174581
Name:ROCHESTER 30 OPCO, LLC
Entity type:Organization
Organization Name:ROCHESTER 30 OPCO, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CORPORATE SECRETARY
Authorized Official - Prefix:MR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:MARGOLIS
Authorized Official - Suffix:
Authorized Official - Credentials:JD, ESQ
Authorized Official - Phone:561-302-2817
Mailing Address - Street 1:1001 BRICKELL BAY DR STE 1504
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33131-4938
Mailing Address - Country:US
Mailing Address - Phone:561-302-2817
Mailing Address - Fax:
Practice Address - Street 1:30 SILVER LAKE PL NW
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55901-3257
Practice Address - Country:US
Practice Address - Phone:507-282-1550
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-01
Last Update Date:2021-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
No174200000XOther Service ProvidersMeals
No177F00000XOther Service ProvidersLodging