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Organization

SUNBRIDGE PUTNAM HEALTH CARE LLC

Active
Parent organization
SUNBRIDGE HEALTHCARE LLC
Other names
Putnam Center
Organization subpart
Yes

Provider details

NPI number
Legal business name
SUNBRIDGE HEALTHCARE LLC
Authorized official
MICHAEL BERG (ASSISTANT SECRETARY)
(505) 821-3355
Entity
Organization

Contact information

Practice address
300 SEVILLE RD, HURRICANE, WV 25526-9206
(304) 757-6805
(304) 757-3803
Mailing address
101 SUN AVE NE, COMPLIANCE DEPARTMENT, ALBUQUERQUE, NM 87109-4373
(505) 468-5604
(505) 468-4681

Taxonomy

Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
91
WV
314000000X
Skilled Nursing Facility
Primary
91
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
#000324427
BCBS
WV
05
0003982000
WV
Enumeration date
05/30/2006
Last updated
08/17/2018
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