Provider Demographics
NPI:1134263155
Name:PARKWAY HEALTHCARE LLC
Entity type:Organization
Organization Name:PARKWAY HEALTHCARE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BILLING SUPERVISOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CHAVIE
Authorized Official - Middle Name:
Authorized Official - Last Name:KATZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-567-0400
Mailing Address - Street 1:96 PARKWAY
Mailing Address - Street 2:
Mailing Address - City:ROCHELLE PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07662
Mailing Address - Country:US
Mailing Address - Phone:718-567-0400
Mailing Address - Fax:718-567-0600
Practice Address - Street 1:96 PARKWAY
Practice Address - Street 2:
Practice Address - City:ROCHELLE PARK
Practice Address - State:NJ
Practice Address - Zip Code:07662-4200
Practice Address - Country:US
Practice Address - Phone:718-567-0400
Practice Address - Fax:718-567-0600
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-16
Last Update Date:2015-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
315308Medicare Oscar/Certification