Provider Demographics
NPI:1558531913
Name:PARKVILLE NURSING AND REHABILITATION
Entity Type:Organization
Organization Name:PARKVILLE NURSING AND REHABILITATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:LINNETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:MILES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-661-1582
Mailing Address - Street 1:8503 HARFORD RD
Mailing Address - Street 2:SUITE F
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21234-4698
Mailing Address - Country:US
Mailing Address - Phone:410-661-1582
Mailing Address - Fax:410-661-1583
Practice Address - Street 1:8503 HARFORD RD
Practice Address - Street 2:SUITE F
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21234-4698
Practice Address - Country:US
Practice Address - Phone:410-661-1582
Practice Address - Fax:410-661-1583
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-01
Last Update Date:2008-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR2583251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health