Emerald Shores Health Care Associates LLC
Organization Active NPI Skilled Nursing Facility · Callaway, FL
NPI 1023093804 · NPPES record last updated Nov 19, 2013
Key facts
- NPI
- 1023093804
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- License
- SNF1292096 (FL)
- Legal business name
- EMERALD SHORES HEALTH CARE ASSOCIATES LLC
- Practice address
- 626 N Tyndall Pkwy
Callaway, FL 32404-6132 - Phone
- (850) 871-6363
- Fax
- (850) 871-6367
- NPI assigned
- Dec 14, 2005
- Organization subpart
- No
Authorized official
- Name
- Jeffrey C. Mark
- Title
- Manager
- Phone
- (850) 871-6363
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | SNF1292096 | FL | Yes |
Addresses
Primary practice location
626 N Tyndall Pkwy
Callaway, FL 32404-6132
Mailing address
626 N Tyndall Pkwy
Callaway, FL 32404-6132
Phone (850) 871-6363
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 025219100 | Medicaid | FL |
Other names
- Emerald Shores Health and Rehabilitation
Other providers in Callaway, FL
- Boyd A Clark
- Compass Physical Therapy
- Aubrie Lynn Dillender
- Haley Nicole Dime
- Brandi Jean Dogoda
- Regina Marie Henderson
- Maria Wright Hobbs
- Haley Howard
- Elizabeth Hunt
- Jacqueline Nichole Jackson
All providers in Callaway, FL · Skilled Nursing Facility in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 19, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.