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Organization
BANNISTER OPERATIONS ASSOC LLC
Active
Organization
BANNISTER OPERATIONS ASSOC LLC
Active
Other names
Bannister Center for Rehabilitation and Healthcare
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JONATHON HAGLER (MEMBER)
(718) 931-9700
Entity
Organization
Contact information
Practice address
135 DODGE ST, STREET, PROVIDENCE, RI 02907-2210
(401) 521-9600
Mailing address
4770 WHITE PLAINS RD, BRONX, NY 10470-1104
(718) 931-9700
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4105038
—
RI
01
—
5005-0
BLUE CROSS
RI
Enumeration date
07/10/2015
Last updated
08/11/2016
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