Provider Demographics
NPI:1881192524
Name:PARAMOUNT NURSING AND REHABILITATION AT FAYETTEVILLE, LLC
Entity type:Organization
Organization Name:PARAMOUNT NURSING AND REHABILITATION AT FAYETTEVILLE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR, ACQUISITIONS&DEVELOPMENT
Authorized Official - Prefix:
Authorized Official - First Name:CHASE
Authorized Official - Middle Name:
Authorized Official - Last Name:DARMSTADTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-204-9723
Mailing Address - Street 1:3025 WASHINGTON RD STE 201
Mailing Address - Street 2:
Mailing Address - City:MC MURRAY
Mailing Address - State:PA
Mailing Address - Zip Code:15317-3246
Mailing Address - Country:US
Mailing Address - Phone:847-204-9723
Mailing Address - Fax:724-969-1050
Practice Address - Street 1:6375 CHAMBERSBURG RD
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:PA
Practice Address - Zip Code:17222-8350
Practice Address - Country:US
Practice Address - Phone:717-352-2721
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PARAMOUNT HEALTH HOLDINGS GROUP, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-01-29
Last Update Date:2018-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility