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NPI Code Detail

MEDICARE: ASBURY ATLANTIC, INC

MEDICARE: ASBURY ATLANTIC, INC
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 FacilityMD

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 : 1497292858
Entity Type Code : Organization
Provider Name (Legal Business Name) : ASBURY ATLANTIC, INC
Provider Business Mailing Address
First Line : 11100 ASBURY CIR
Second Line :
City : SOLOMONS
State : MD
Zip : 20688-3004
Country : US
Telephone Number : 410-394-3000
Fax Number : 410-394-3008
Provider Business Practice Location Address
First Line : 11100 ASBURY CIR
Second Line :
City : SOLOMONS
State : MD
Zip : 20688-3004
Country : US
Telephone Number : 410-394-3000
Fax Number : 410-394-3008
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : MR. BRAD ANDRUS
Credential : M.A, M.AGS
Telephone Number : 410-394-3030
Provider Enumeration Date : 01/24/2017
Last Update Date : 04/20/2017

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1811429384 — ASBURY ATLANTIC, INC
Practice Location Address:
11100 ASBURY CIR
SOLOMONS, MD
20688-3004
Practice Phone: 410-394-3000
Practice Fax: 410-394-3008

Directions to “ASBURY ATLANTIC, INC ” Practice Location

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