Healthcare Provider Details

I. General information

NPI: 1851282255
Provider Name (Legal Business Name): MDICS REHABILITATIVE SERVICES - LTCACO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2025
Last Update Date: 07/14/2025
Certification Date: 07/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 VAN BUREN ST
ANNAPOLIS MD
21403-2124
US

IV. Provider business mailing address

PO BOX 69231
BALTIMORE MD
21264-9231
US

V. Phone/Fax

Practice location:
  • Phone: 410-267-8653
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DAVID SWEATT
Title or Position: CFO
Credential:
Phone: 240-841-8714