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NPI Code Detail

MEDICARE: NEW ANNAPOLIS NURSING LLC

MEDICARE: NEW ANNAPOLIS NURSING LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1314000000XSkilled Nursing Facility02002MD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1265439004
Entity Type Code : Organization
Provider Name (Legal Business Name) : NEW ANNAPOLIS NURSING LLC
Provider Business Mailing Address
First Line : 900 VAN BUREN ST
Second Line :
City : ANNAPOLIS
State : MD
Zip : 21403-2124
Country : US
Telephone Number : 301-858-5810
Fax Number :
Provider Business Practice Location Address
First Line : 900 VAN BUREN ST
Second Line :
City : ANNAPOLIS
State : MD
Zip : 21403-2124
Country : US
Telephone Number : 301-858-5810
Fax Number :
Authorized Official
Title or Position : ADMINISTRATOR OWNER
Name : MR. MATTHEW NEISWANGER
Credential :
Telephone Number : 301-864-2333
Provider Enumeration Date : 07/07/2005
Last Update Date : 10/23/2008

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Directions to “NEW ANNAPOLIS NURSING LLC ” Practice Location

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