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General NPI Number Information
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NPI Number | 1508680018
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Entity Type | Organization
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Legal Business Name | EASTERN SHORE OPERATOR LLC
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Dates
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Enumeration Date | 11/12/2024
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Last Update Date | 11/18/2024
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Provider Practice Location Address
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Address Line | 1205 S 28TH ST
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City | HARRISBURG
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State | PA
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Zip | 17111-1046
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Country | US
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Telephone | 717-565-7000
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Fax |
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Provider Business Mailing Address
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Address Line | 1205 S 28TH ST
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City | HARRISBURG
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State | PA
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Zip | 17111-1046
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Country | US
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Telephone | 717-565-7000
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Fax |
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Authorized Official
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Title or Position | MEDICARE ADMINISTRATION OFFICER
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Name | MINDEE POSEN
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Credential |
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Telephone | 845-825-2217
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State |
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