Provider Demographics
NPI:1598759854
Name:SNOW HILL NURSING AND REHAB CENTER, LLC
Entity type:Organization
Organization Name:SNOW HILL NURSING AND REHAB CENTER, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:RICHETTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-383-4225
Mailing Address - Street 1:430 W MARKET ST
Mailing Address - Street 2:
Mailing Address - City:SNOW HILL
Mailing Address - State:MD
Mailing Address - Zip Code:21863-1127
Mailing Address - Country:US
Mailing Address - Phone:410-632-3755
Mailing Address - Fax:410-632-3708
Practice Address - Street 1:430 W MARKET ST
Practice Address - Street 2:
Practice Address - City:SNOW HILL
Practice Address - State:MD
Practice Address - Zip Code:21863-1127
Practice Address - Country:US
Practice Address - Phone:410-632-3755
Practice Address - Fax:410-632-3708
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-01
Last Update Date:2008-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD23003314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD831901400Medicaid
MD415339100Medicaid
MD403853300Medicaid
MD831901400Medicaid