Healthcare Provider Details

I. General information

NPI: 1548261803
Provider Name (Legal Business Name): CARENET HEALTH SYSTEMS & SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/09/2005
Last Update Date: 06/19/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

705 MIDWAY AVE
MOUNT AIRY MD
21771-2861
US

IV. Provider business mailing address

705 MIDWAY AVE
MOUNT AIRY MD
21771-2861
US

V. Phone/Fax

Practice location:
  • Phone: 301-829-6050
  • Fax: 301-829-9065
Mailing address:
  • Phone: 301-829-6050
  • Fax: 301-829-9065

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number06021
License Number StateMD

VIII. Authorized Official

Name: MR. LOUIS G GRIMMEL
Title or Position: CEO
Credential:
Phone: 410-750-7500