Healthcare Provider Details

I. General information

NPI: 1568380707
Provider Name (Legal Business Name): LL AMDC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2525 LORD BALTIMORE DR STE B
BALTIMORE MD
21244-2671
US

IV. Provider business mailing address

2525 LORD BALTIMORE DR STE B
BALTIMORE MD
21244-2671
US

V. Phone/Fax

Practice location:
  • Phone: 410-402-5344
  • Fax:
Mailing address:
  • Phone: 410-402-5344
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: RAJESHWER REDDY PINGILI
Title or Position: MANAGER
Credential: RPH
Phone: 410-979-7732