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GRAND VICTORIAN OF ROCKFORD, LLC

Point of Service

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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Contact Information

GRAND VICTORIAN OF ROCKFORD, LLC
3495 MCFARLAND RD
ROCKFORD, IL  61114-5609
 Phone: 815-654-1400
 Fax: 815-654-1488
 Website:
 

Specialty

 Taxonomy Code Specialty Code Provider Type

Point of Service

 305S00000X
Indicates primary specialty

NPI Profile & details for GRAND VICTORIAN OF ROCKFORD, LLC

NPI # 1891991550
LBN Legal business name GRAND VICTORIAN OF ROCKFORD, LLC
Authorized official JOHN HOLTZ - (CONTROLLER)
Entity Organization
Organization subpart 1 No
Enumeration date 06/21/2007
Last updated 05/13/2008 - About 18 years ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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