Organization
MANOR CARE OF POTOMAC MD LLC
Active
Other names
ProMedica Skilled Nursing and Rehabilitation (Potomac)
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARTIN D ALLEN (DIRECTOR)
(419) 252-5734
Entity
Organization
Contact information
Practice address
10714 POTOMAC TENNIS LN, POTOMAC, MD 20854-4418
(301) 299-2273
(301) 299-1631
Mailing address
333 N SUMMIT ST, TOLEDO, OH 43604-2615
(419) 252-5500
(877) 385-9446
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
15219
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
413522900
—
MD
01
—
HH5
CAREFIRST BLUE CROSS
MD
Enumeration date
07/22/2005
Last updated
01/25/2022
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