Aslc Opco MD I, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

03-019 Issued in MD

Legal business name

ASLC OPCO MD I, LLC

Doing business as

Ivy Hall Geriatric Center

Practice address

1300 Windlass Dr
Baltimore, MD 21220-4126

Phone

(410) 687-1383

Fax

(410) 682-4174

NPI assigned

Dec 13, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Robert V Gibbs

Title

President

Phone

(732) 708-1946

Specialties & licenses 1

Addresses

Other names 1

• Ivy Hall Geriatric Center Doing business as

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1760543367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 WINDLASS DR",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212204126",
            "telephone_number": "410-687-1383",
            "fax_number": "410-682-4174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 WINDLASS DR",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212204126",
            "telephone_number": "410-687-1383",
            "fax_number": "410-682-4174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASLC OPCO MD I, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GIBBS",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "732-708-1946",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MD",
            "license": "03-019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ivy Hall Geriatric Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Frederic B Askin, M.D.
• Tyniya Askins
• Aishah Aslam, DO
• Alesha Aslam
• Mohammad Omer Aslam, M.D.
• Nazli Aslinejad
• Fekadu Asmare
• Mercy Mundih Asong, PHARMD
• Akintomide Jerry Asooto
• Rebecca Aspden

• Skilled Nursing Facility in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Skilled Nursing Facility in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.