Healthcare Provider Details

I. General information

NPI: 1659361905
Provider Name (Legal Business Name): RUXTON HEALTHCARE II LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/27/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 SUDBROOK LN
PIKESVILLE MD
21208-4118
US

IV. Provider business mailing address

7 SUDBROOK LN
PIKESVILLE MD
21208-4118
US

V. Phone/Fax

Practice location:
  • Phone: 410-486-8771
  • Fax: 410-484-3080
Mailing address:
  • Phone: 410-486-8771
  • Fax: 410-484-3080

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number03028
License Number StateMD

VIII. Authorized Official

Name: MRS. SUSAN STONE
Title or Position: ADMINISTRATOR
Credential:
Phone: 410-486-8771