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General NPI Number Information
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NPI Number | 1922647486
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Entity Type | Organization
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Legal Business Name | AXIS HEALTH AT FROSTBURG OPCO LLC
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Dates
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Enumeration Date | 01/02/2020
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Last Update Date | 01/02/2020
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Provider Practice Location Address
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Address Line | 48 TARN TER
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City | FROSTBURG
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State | MD
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Zip | 21532-1242
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Country | US
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Telephone | --
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Fax |
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Provider Business Mailing Address
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Address Line | 22 PLEASANT RIDGE RD
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City | SPRING VALLEY
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State | NY
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Zip | 10977-1609
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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 | MEMBER
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Name | BENT PHILIPSON
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Credential |
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Telephone | 516-565-1900
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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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