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General NPI Number Information
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NPI Number | 1760598155
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Entity Type | Organization
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Legal Business Name | BOWIE CENTER LIMITED PARTNERSHIP
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Dates
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Enumeration Date | 08/21/2006
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Last Update Date | 08/14/2020
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Provider Practice Location Address
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Address Line | 15005 HEALTH CENTER DR
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City | BOWIE
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State | MD
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Zip | 20716-1017
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Country | US
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Telephone | 301-805-6070
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Fax | 301-805-9856
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Provider Business Mailing Address
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Address Line | 101 E STATE ST
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City | KENNETT SQUARE
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State | PA
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Zip | 19348-3109
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Country | US
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Telephone | 610-444-6350
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Fax |
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Authorized Official
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Title or Position | ASSISTANT SECRETARY
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Name | MICHAEL T. BERG
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Credential |
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Telephone | 505-468-4752
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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 | 16-035
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License Number State | MD
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