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General NPI Number Information
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NPI Number | 1770050106
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Entity Type | Organization
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Legal Business Name | PIKESVILLE OPERATOR, LLC
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Dates
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Enumeration Date | 10/24/2018
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Last Update Date | 10/24/2018
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Provider Practice Location Address
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Address Line | 7 SUDBROOK LN
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City | PIKESVILLE
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State | MD
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Zip | 21208-4118
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Country | US
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Telephone | 410-486-8771
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Fax | 410-484-3080
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Provider Business Mailing Address
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Address Line | 14C 53RD ST STE 220
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City | BROOKLYN
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State | NY
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Zip | 11232-2644
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | SAM STERN
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Credential |
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Telephone | 718-567-0400
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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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