Healthcare Provider Details

I. General information

NPI: 1982894648
Provider Name (Legal Business Name): JOSEPH RICHEY HOUSE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2007
Last Update Date: 03/06/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

838 N EUTAW ST
BALTIMORE MD
21201-4624
US

IV. Provider business mailing address

838 N EUTAW ST
BALTIMORE MD
21201-4624
US

V. Phone/Fax

Practice location:
  • Phone: 410-523-2150
  • Fax:
Mailing address:
  • Phone: 410-523-2150
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License NumberH1514
License Number StateMD

VIII. Authorized Official

Name: MISS ANGELA C WILKES
Title or Position: BILLING
Credential:
Phone: 410-523-2150