Healthcare Provider Details

I. General information

NPI: 1639983422
Provider Name (Legal Business Name): SHORE HEALTH SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/03/2025
Last Update Date: 02/03/2025
Certification Date: 02/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11901 GEORGIA AVE
SILVER SPRING MD
20902-2001
US

IV. Provider business mailing address

511 GRAND CYPRESS CT
ASHTON MD
20861-8019
US

V. Phone/Fax

Practice location:
  • Phone: 410-443-7060
  • Fax:
Mailing address:
  • Phone: 410-443-7060
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: ASIMA S. CHEEMA
Title or Position: OWNER
Credential: MD
Phone: 410-443-7060