Provider Demographics
NPI:1982057147
Name:GSHN OPERATOR LLC
Entity Type:Organization
Organization Name:GSHN OPERATOR LLC
Other - Org Name:FUTURECARE AT GOOD SAMARITAN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:FINGLASS
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:410-766-1995
Mailing Address - Street 1:8028 RITCHIE HWY
Mailing Address - Street 2:SUITE 210B
Mailing Address - City:PASADENA
Mailing Address - State:MD
Mailing Address - Zip Code:21122-1075
Mailing Address - Country:US
Mailing Address - Phone:410-766-1995
Mailing Address - Fax:410-761-6095
Practice Address - Street 1:1601 E BELVEDERE AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21239-3004
Practice Address - Country:US
Practice Address - Phone:410-532-5600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-22
Last Update Date:2016-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
215241Medicare Oscar/Certification