Healthcare Provider Details

I. General information

NPI: 1235323221
Provider Name (Legal Business Name): GENERALHEALTHCARERESOURCES,INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/01/2007
Last Update Date: 04/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2716 HARLEM AVE
BALTIMORE MD
21216-4716
US

IV. Provider business mailing address

2716 HARLEM AVE
BALTIMORE MD
21216-4716
US

V. Phone/Fax

Practice location:
  • Phone: 443-708-4231
  • Fax:
Mailing address:
  • Phone: 443-708-4231
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License NumberLP13375
License Number StateMD

VIII. Authorized Official

Name: MS. CORA THELMA BULLOCK
Title or Position: LPN
Credential: LP13375
Phone: 443-708-4231