Healthcare Provider Details
I. General information
NPI: 1013043470
Provider Name (Legal Business Name): ACSR, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/27/2007
Last Update Date: 09/13/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1430 MAIN ST S
BROWNSVILLE KY
42210
US
IV. Provider business mailing address
400 REDLAND CT SUITE 114
OWINGS MILLS MD
21117-3270
US
V. Phone/Fax
- Phone: 270-597-8387
- Fax: 270-597-8389
- Phone: 443-548-2200
- Fax: 443-548-2260
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 347E00000X |
| Taxonomy | Transportation Broker |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
KRIS
W.
BALDOCK
Title or Position: CHAIRMAN, CEO, PRESIDENT
Credential:
Phone: 443-548-2201