HERMITAGE HEALTHCARE OF MANOKIN MANOR, LLC
Nursing Care, Pediatric
Princess Anne, Maryland
Provider NPI: 1790795672
Organization Information:Organization Name: HERMITAGE HEALTHCARE OF MANOKIN MANOR, LLC
Practice Location:
11974 EDGEHILL TERRACE RD PRINCESS ANNE, MD 21853 US
Tel: 410-651-0011 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Other Provider Identifiers:
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
Practice Location:
11974 EDGEHILL TERRACE RD PRINCESS ANNE, MD 21853 US
Tel: 410-651-0011 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
Y | 3140N1450X | Nursing & Custodial Care Facilities Skilled Nursing Facility Nursing Care, Pediatric |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
19002 | MD | 05 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin