3001 Palm Coast Parkway Operations LLC
Organization Active NPI Skilled Nursing Facility · Palm Coast, FL
NPI 1083983720 · NPPES record last updated Nov 27, 2023
Key facts
- NPI
- 1083983720
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- License
- SNF130470968 (FL)
- Legal business name
- 3001 PALM COAST PARKWAY OPERATIONS LLC
- Practice address
- 3001 Palm Coast Pkwy SE
Palm Coast, FL 32137-8209 - Phone
- (386) 446-6060
- Fax
- (386) 446-6033
- NPI assigned
- Dec 27, 2011
- Organization subpart
- No
Authorized official
- Name
- Kenneth Ussery
- Title
- VP
- Phone
- (407) 571-1550
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | SNF130470968 | FL | Yes |
Addresses
Primary practice location
3001 Palm Coast Pkwy SE
Palm Coast, FL 32137-8209
Mailing address
3001 Palm Coast Pkwy SE
Palm Coast, FL 32137-8209
Phone (386) 446-6060
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 004386400 | Medicaid | FL |
Other names
- Grand Oaks Health and Rehabilitation Center
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://65.196.137.118:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service | Other |
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All providers in Palm Coast, 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 27, 2023. 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.