Provider Demographics
NPI:1376593004
Name:ROWLAND CONVALESCENT HOSPITAL INC
Entity Type:Organization
Organization Name:ROWLAND CONVALESCENT HOSPITAL INC
Other - Org Name:THE ROWLAND
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:KALOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-967-2741
Mailing Address - Street 1:330 W ROWLAND ST
Mailing Address - Street 2:
Mailing Address - City:COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91723-2941
Mailing Address - Country:US
Mailing Address - Phone:626-967-2741
Mailing Address - Fax:626-332-3781
Practice Address - Street 1:330 W ROWLAND ST
Practice Address - Street 2:
Practice Address - City:COVINA
Practice Address - State:CA
Practice Address - Zip Code:91723-2941
Practice Address - Country:US
Practice Address - Phone:626-967-2741
Practice Address - Fax:626-332-3781
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-11
Last Update Date:2010-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA950000089314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZT06117IMedicaid
CA056117Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER