Provider Demographics
NPI:1124090998
Name:FMSC WHARTON OPERATING COMPANY LP
Entity type:Organization
Organization Name:FMSC WHARTON OPERATING COMPANY LP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP OF REIMBURSMENTS
Authorized Official - Prefix:MR
Authorized Official - First Name:NELSON
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBAINA
Authorized Official - Suffix:JR
Authorized Official - Credentials:BS
Authorized Official - Phone:305-892-1790
Mailing Address - Street 1:418 N RUSK ST
Mailing Address - Street 2:
Mailing Address - City:WHARTON
Mailing Address - State:TX
Mailing Address - Zip Code:77488-3924
Mailing Address - Country:US
Mailing Address - Phone:979-532-5020
Mailing Address - Fax:
Practice Address - Street 1:418 N RUSK ST
Practice Address - Street 2:
Practice Address - City:WHARTON
Practice Address - State:TX
Practice Address - Zip Code:77488-3924
Practice Address - Country:US
Practice Address - Phone:979-532-5020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXN/AMedicare UPIN
TX67-5361Medicare ID - Type Unspecified