Provider Demographics
NPI:1760455158
Name:FMSC EDNA OPERATING COMPANY LP
Entity Type:Organization
Organization Name:FMSC EDNA OPERATING COMPANY LP
Other - Org Name:CARE INN OF EDNA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP OF REIMBURSMENTS
Authorized Official - Prefix:MR
Authorized Official - First Name:NELSON
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBAINA
Authorized Official - Suffix:JR
Authorized Official - Credentials:BS
Authorized Official - Phone:305-892-1790
Mailing Address - Street 1:1680 MICHIGAN AVE STE 736
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33139-2551
Mailing Address - Country:US
Mailing Address - Phone:305-892-1790
Mailing Address - Fax:
Practice Address - Street 1:1204 N WELLS ST
Practice Address - Street 2:
Practice Address - City:EDNA
Practice Address - State:TX
Practice Address - Zip Code:77957-2149
Practice Address - Country:US
Practice Address - Phone:361-782-3581
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
675994Medicare ID - Type Unspecified