Provider Demographics
NPI:1669838439
Name:LAUREL LEASING CO., LLC
Entity Type:Organization
Organization Name:LAUREL LEASING CO., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:STOLTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-530-1613
Mailing Address - Street 1:100 LAUREL DR
Mailing Address - Street 2:
Mailing Address - City:ELKTON
Mailing Address - State:MD
Mailing Address - Zip Code:21921-5328
Mailing Address - Country:US
Mailing Address - Phone:513-489-7100
Mailing Address - Fax:513-489-7199
Practice Address - Street 1:100 LAUREL DR
Practice Address - Street 2:
Practice Address - City:ELKTON
Practice Address - State:MD
Practice Address - Zip Code:21921-5328
Practice Address - Country:US
Practice Address - Phone:513-489-7100
Practice Address - Fax:513-489-7199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-11
Last Update Date:2022-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD215111Medicare Oscar/Certification