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General NPI Number Information
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NPI Number | 1730973595
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Entity Type | Organization
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Legal Business Name | GLENWOOD OPCO LLC
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Dates
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Enumeration Date | 04/07/2025
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Last Update Date | 07/03/2025
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Provider Practice Location Address
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Address Line | 41 N FIFTH ST
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City | GLENWOOD
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State | GA
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Zip | 30428-3701
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Country | US
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Telephone | 912-523-5102
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Fax | 912-523-2182
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Provider Business Mailing Address
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Address Line | 41 N FIFTH ST
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City | GLENWOOD
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State | GA
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Zip | 30428-3701
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Country | US
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Telephone | 912-523-5102
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Fax | 912-523-2182
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Authorized Official
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Title or Position | MANAGER
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Name | DOVID A FISCHER
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Credential |
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Telephone | 732-606-2773
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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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