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NPI Code Detail

MEDICARE: OAK MANOR HEALTHCARE CENTER, LLC

MEDICARE: OAK MANOR HEALTHCARE CENTER, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1314000000XSkilled Nursing Facility

General Provider Information

NPI Number : 1023505054
Entity Type Code : Organization
Provider Name (Legal Business Name) : OAK MANOR HEALTHCARE CENTER, LLC
Provider Business Mailing Address
First Line : 8227 CLOVERLEAF DR STE 309
Second Line :
City : MILLERSVILLE
State : MD
Zip : 21108-1536
Country : US
Telephone Number : 410-729-8406
Fax Number : 410-987-2430
Provider Business Practice Location Address
First Line : 3415 GREENCASTLE RD
Second Line :
City : BURTONSVILLE
State : MD
Zip : 20866-1715
Country : US
Telephone Number : 410-729-8406
Fax Number : 410-987-2430
Authorized Official
Title or Position : DIRECTOR OF FACILITY ACCOUNTING
Name : BARBARA KITCHEN
Credential :
Telephone Number : 410-729-8406
Provider Enumeration Date : 04/16/2018
Last Update Date : 04/16/2018

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Directions to “OAK MANOR HEALTHCARE CENTER, LLC ” Practice Location

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