Granite MD Opco
NPI #1952009516 in Randallstown, Maryland
Provider Information
- NPI Number
- 1952009516
- Entity Type
- Organization
- Organization Name
- Granite MD Opco
- Primary Specialty
- Skilled Nursing Facility
- Enumeration Date
- Feb 22, 2023
- Last Updated
- Sep 10, 2023
Practice Location
- Address
- 9109 LIBERTY RD
- City
- Randallstown
- State
- Maryland
- ZIP Code
- 21133-3521
- Phone
- (410) 655-7373
Authorized Official
- Name
- JACK PANETH
- Title
- AUTHORIZED OFFICIAL
- Phone
- (410) 655-7373
Specialties & Taxonomy Codes
| Specialty |
|---|
| Skilled Nursing Facility |
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