3865 TAMPA ROAD LLC
Nursing at Tampa Rd, Oldsmar, FL

License number
Florida SNF 1591096
Category
Nursing
Type
Skilled Nursing Facility
Owner
Name: WILLIAM A MATHIES
Title: PRESIDENT DIRECTOR
Phone: (505) 821-3355
Address
Address 2
3865 Tampa Rd, Oldsmar, FL 34677
101 Sun Ave NE DEPARTMENT COMPLIANCE, Albuquerque, NM 87109
National Provider ID: 1487678132
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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3865 TAMPA ROAD, LLC

Kennett Sq, PA  -  Oldsmar, FL  -  Albuquerque, NM

Industry:
Skilled Nursing Care Facility
Doing business as:
West Bay Care Rhbilitation Ctr
Registration:
Jun 4, 2001
Addresses:
101 E State St, Kennett Square, PA 19348 (Physical)
3865 Tampa Rd, Oldsmar, FL 34677
101 Sun Ave NE, Albuquerque, NM 87109
State ID:
M01000001250
Business type:
Foreign Limited Liability Company
Entity State:
DE
Managing Members:
Hager, George V, Jr, 101 E State St, Kennett Square, PA 19348 (Physical),Robert A Reitz (Vice President), 101 E State St, Kennett Square, PA 19348 (Physical),Thomas Divittorio (CFO, Chairman), 101 E State St, Kennett Square, PA 19348 (Physical),...
Agent:
Corporation Service Company
EIN:
061621885

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