Shady Grove Center

LBN: 9701 Medical Center Drive Operations Llc
Shady Grove Center is an health care organization with primary practice located at 9701 Medical Center Dr , Rockville MD 20850-3326. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Skilled Nursing Facility, which is considered as the primary health care specialty. 9701 Medical Center Drive Operations Llc can be contacted via phone (301) 315-1900, or through Berg, Michael T. via phone (505) 468-4752.

Contact Information

Primary practice address
9701 Medical Center Dr Rockville MD 20850-3326
Phone: (301) 315-1900
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Berg, Michael T.
Phone: (505) 468-4752

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Skilled Nursing Facility 314000000X 15009 Maryland

Profile Details

NPI number 1609184753
LBN Legal business name 9701 Medical Center Drive Operations Llc
DBA Doing business as Shady Grove Center
Authorized official Berg, Michael T.
Entity Organization
Organization subpart 1 No
Enumeration date Sep 22nd, 2010
Last updated Jan 8th, 2016 - about 8 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1609184753 NPPES
Maryland MEDICAID 562108900
Maryland MEDICAID 158057400

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