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NPI Code Detail

MEDICARE: PINEVIEW EXTENDED CARE CENTRE, INC.

MEDICARE: PINEVIEW EXTENDED CARE CENTRE, INC.
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 Facility16-032MD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1578927588
Entity Type Code : Organization
Provider Name (Legal Business Name) : PINEVIEW EXTENDED CARE CENTRE, INC.
Provider Business Mailing Address
First Line : 8028 RITCHIE HWY
Second Line : SUITE 210B
City : PASADENA
State : MD
Zip : 21122-1075
Country : US
Telephone Number : 410-766-1995
Fax Number : 410-461-6095
Provider Business Practice Location Address
First Line : 9016 PINE VIEW LANE
Second Line :
City : CLINTON
State : MD
Zip : 20735-3229
Country : US
Telephone Number : 410-647-0015
Fax Number : 410-647-0019
Authorized Official
Title or Position : VP OF FINANCE
Name : MR. BRIAN FINGLASS
Credential : CFO
Telephone Number : 410-766-1995
Provider Enumeration Date : 04/06/2016
Last Update Date : 04/06/2016

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