MEDICARE: RHODA VERONICA BLACKWOOD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	374U00000X	Home Health Aide

General Provider Information

NPI Number	:	1164297511
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RHODA VERONICA BLACKWOOD

Provider Business Mailing Address
First Line	:	2914 E JOPPA RD STE 201
Second Line	:
City	:	PARKVILLE
State	:	MD
Zip	:	21234-3045
Country	:	US
Telephone Number	:	410-961-6850
Fax Number	:	410-882-0790

Provider Business Practice Location Address
First Line	:	2914 E JOPPA RD STE 201
Second Line	:
City	:	PARKVILLE
State	:	MD
Zip	:	21234-3045
Country	:	US
Telephone Number	:	410-961-6850
Fax Number	:	410-882-0790

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/15/2023
Last Update Date	:	11/15/2023

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Directions to “ RHODA VERONICA BLACKWOOD ” Practice Location

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