Healthcare Provider Details

I. General information

NPI: 1053353581
Provider Name (Legal Business Name): MARYLAND HEALTH CARE RESOURCES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2901 DRUID PARK DR A102
BALTIMORE MD
21215-8102
US

IV. Provider business mailing address

2901 DRUID PARK DR A102
BALTIMORE MD
21215-8102
US

V. Phone/Fax

Practice location:
  • Phone: 410-523-7400
  • Fax: 410-523-4034
Mailing address:
  • Phone: 410-523-7400
  • Fax: 410-523-4034

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License NumberR1184R
License Number StateMD

VIII. Authorized Official

Name: MS. PATRICIA MEDLEY
Title or Position: PRESIDENT
Credential:
Phone: 410-523-7400