The Vindobona, Inc.
Organization Active NPI Skilled Nursing Facility · Braddock Heights, MD
NPI 1730160805 · NPPES record last updated Nov 4, 2011
Key facts
- NPI
- 1730160805
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- License
- 10005 (MD)
- Legal business name
- THE VINDOBONA, INC.
- Practice address
- 6012 Jefferson Blvd
Braddock Heights, MD 21714 - Phone
- (301) 371-7160
- Fax
- (301) 371-5921
- NPI assigned
- Nov 7, 2005
- Organization subpart
- No
Authorized official
- Name
- Mr. Randall Scott Martin
- Title
- Secretary/Treasurer
- Phone
- (301) 371-7160
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 21D0711755 | Vindobona Nursing Home Inc,the | Certificate of waiver | Aug 31, 2026 |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 10005 | MD | Yes |
Addresses
Primary practice location
6012 Jefferson Blvd
Braddock Heights, MD 21714
Mailing address
PO Box 318
Braddock Heights, MD 21714-0318
Phone (301) 371-7160
Other names
- Vindobona Nursing Home
Other providers in Braddock Heights, MD
- Penelope A McQuarrie
- Richard Donald McQuarrie
- Heba M I Metwally
- Leslie Pannucci
- South Mountain Rehabilitation Inc
- Lisa Freeman Tragert
All providers in Braddock Heights, MD · Skilled Nursing Facility in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 4, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.