Grand Victorian Of Rockford, Llc in Rockford - Point Of Service
Grand Victorian Of Rockford, Llc - NPI 1891991550
Grand Victorian Of Rockford, Llc is a Point Of Service in Rockford, Illinois. Grand Victorian Of Rockford, Llc practices all healthcare services and medical treatments related to Point Of Service. The NPI Number for Grand Victorian Of Rockford, Llc is 1891991550. The last update date is 2008-05-13.
Grand Victorian Of Rockford, Llc's current location address is 3495 Mcfarland Rd, Rockford, Illinois. You can contact this provider via phone number 8156541400 and fax number 8156541488. The mailing address for Grand Victorian Of Rockford, Llc is 3495 Mcfarland Rd, Rockford, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Grand Victorian Of Rockford, Llc |
|---|---|
| Address | 3495 Mcfarland Rd, Rockford, Illinois |
| Phone Number | 8156541400 |
| Fax Number | 8156541488 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | CONTROLLER |
|---|---|
| Authorized Official Name | Holtz John |
| Telephone Number | 5417473373 |
NPI Number Detail
| NPI Number | 1891991550 |
|---|---|
| Provider Enumeration Date | 2007-06-21 |
| Last Updated Date | 2008-05-13 |
Provider Mailing Address Detail
| Address | 3495 Mcfarland Rd |
|---|---|
| City | Rockford |
| State | Illinois (IL) |
| Post Code | 611145609 |
| Phone Number | 8156541400 |
| Fax Number | 8156541488 |
Provider's Primary Taxonomy Detail
| Speciality | Point Of Service |
|---|---|
| Taxonomy | 305S00000X |
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Definition: This product may also be called an open-ended HMO and offers a transition product incorporating features of both HMOs and PPOs. Beneficiaries are enrolled in an HMO but have the option to go outside the networks for an additional cost. |
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What is the Grand Victorian Of Rockford, Llc's 1891991550?
The Grand Victorian Of Rockford, Llc's NPI (National Provider Identifier) Number is 1891991550. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Could you please share the complete physical location address where Grand Victorian Of Rockford, Llc's facilities are situated?
The facilities of Grand Victorian Of Rockford, Llc are physically located at the following address: 3495 Mcfarland Rd, Rockford, IL, 611145609.
What is the Grand Victorian Of Rockford, Llc's area of specialization and corresponding taxonomy classification?
The Grand Victorian Of Rockford, Llc's specialty field is Point Of Service, and it falls under the taxonomy code 305S00000X, which categorizes healthcare providers based on their specialties.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1891991550 to Grand Victorian Of Rockford, Llc?
The Centers for Medicare & Medicaid Services originally issued the 1891991550 to Grand Victorian Of Rockford, Llc on 2007-06-21.
When was the information related to Grand Victorian Of Rockford, Llc most recently updated or refreshed?
The details pertaining to the Grand Victorian Of Rockford, Llc, including its address, specialty, and other relevant information, were last updated or refreshed on 2008-05-13.
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