19301 Watkins Mill Road Operating Company, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

19301 WATKINS MILL ROAD OPERATING COMPANY, LLC

Practice address

19301 Watkins Mill Rd.
Montgomery Village, MD 20886

Phone

(301) 527-2500

Fax

(301) 527-2525

NPI assigned

Jul 14, 2005

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. A. Alberto Lugo

Title

Executive VP & General Counsel

Phone

(201) 242-4000

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Montgomery Village Health Care Center Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1121299200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1439424000000",
    "number": "1316945181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19301 WATKINS MILL RD.",
            "city": "MONTGOMERY VILLAGE",
            "state": "MD",
            "postal_code": "20886",
            "telephone_number": "301-527-2500",
            "fax_number": "301-527-2525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19301 WATKINS MILL RD.",
            "city": "MONTGOMERY VILLAGE",
            "state": "MD",
            "postal_code": "20886",
            "telephone_number": "301-527-2500",
            "fax_number": "301-527-2525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "19301 WATKINS MILL ROAD OPERATING COMPANY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-14",
        "last_updated": "2015-08-13",
        "status": "A",
        "authorized_official_last_name": "LUGO",
        "authorized_official_first_name": "A.",
        "authorized_official_middle_name": "ALBERTO",
        "authorized_official_title_or_position": "EXECUTIVE VP & GENERAL COUNSEL",
        "authorized_official_telephone_number": "201-242-4000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MD",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "402642000",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Montgomery Village Health Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• All providers in Montgomery Village, MD
• Skilled Nursing Facility in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.