Provider Demographics
NPI:1639057417
Name:AUBURN OPCO LLC
Entity type:Organization
Organization Name:AUBURN OPCO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:MOSHE
Authorized Official - Middle Name:
Authorized Official - Last Name:KELMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-542-4111
Mailing Address - Street 1:139 PEARL ST
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:KY
Mailing Address - Zip Code:42206-5121
Mailing Address - Country:US
Mailing Address - Phone:270-542-4111
Mailing Address - Fax:270-542-7026
Practice Address - Street 1:139 PEARL ST
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:KY
Practice Address - Zip Code:42206-5121
Practice Address - Country:US
Practice Address - Phone:270-542-4111
Practice Address - Fax:270-542-7026
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-21
Last Update Date:2025-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY100295OtherLICENSE