Healthcare Provider Details

I. General information

NPI: 1699960625
Provider Name (Legal Business Name): NMS HEALTHCARE OF HYATTSVILLE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2007
Last Update Date: 09/10/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4922 LASALLE RD
HYATTSVILLE MD
20782-3302
US

IV. Provider business mailing address

4922 LASALLE RD
HYATTSVILLE MD
20782-3302
US

V. Phone/Fax

Practice location:
  • Phone: 301-864-2333
  • Fax: 301-864-1377
Mailing address:
  • Phone: 301-864-2333
  • Fax: 301-864-1377

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number StateMD

VIII. Authorized Official

Name: MR. JOSEPH NASRAWY
Title or Position: CFO
Credential:
Phone: 301-864-2333