Healthcare Provider Details

I. General information

NPI: 1053455162
Provider Name (Legal Business Name): PREFERRED HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2007
Last Update Date: 12/10/2024
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4211 BLAKELY AVENUE SUITE 200
BALTIMORE MD
21236-2258
US

IV. Provider business mailing address

4134 E JOPPA RD SUITE 202
BALTIMORE MD
21236-2284
US

V. Phone/Fax

Practice location:
  • Phone: 410-248-9800
  • Fax: 410-248-9801
Mailing address:
  • Phone: 410-248-9800
  • Fax: 410-248-9801

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberR2479
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. RONALD D JONES
Title or Position: CFO
Credential:
Phone: 410-248-9800