Healthcare Provider Details

I. General information

NPI: 1760913297
Provider Name (Legal Business Name): REK ADVANCED THERAPEUTIC SOLUTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6419 YORK RD # A STE 100
BALTIMORE MD
21212-2144
US

IV. Provider business mailing address

6419 YORK RD # A STE 100
BALTIMORE MD
21212-2144
US

V. Phone/Fax

Practice location:
  • Phone: 540-760-6285
  • Fax:
Mailing address:
  • Phone: 540-760-6285
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RA0401X
TaxonomyAddiction Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. REGINALD DENNIS
Title or Position: CEO
Credential:
Phone: 540-760-6285