NPI 1104265644 · live from the CMS NPI Registry
Bayshore Duluth Management, LLC
Skilled Nursing Facility in Duluth, MN. National Provider Identifier 1104265644, active.
NPI record
| NPI | 1104265644 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Skilled Nursing Facility 314000000X |
| Practice location | 1601 Saint Louis Ave, Duluth, MN 55802 |
| Practice phone | 218-727-8651 |
| Mailing address | 7150 Parsons Blvd, Ste 1001, Flushing, NY 11365 |
| Enumerated | June 18, 2013 |
| Last updated | June 18, 2013 |
| Authorized official | Eliezer Deitsch, Manager |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Skilled Nursing Facility primary | 314000000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.