4140 OLD WASHINGTON HIGHWAY OPERATIONS LLC
Skilled Nursing Facility
Waldorf, Maryland
Provider NPI: 1861673428
Organization Information:Organization Name: 4140 OLD WASHINGTON HIGHWAY OPERATIONS LLC
Practice Location:
4140 OLD WASHINGTON RD WALDORF, MD 20602 US
Tel: 301-645-2813 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:
4140 OLD WASHINGTON RD WALDORF, MD 20602 US
Tel: 301-645-2813 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
Y | 314000000X | Nursing & Custodial Care Facilities Skilled Nursing Facility | MD | 08-006 |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
413976300 | MD | 05 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin