Healthcare Provider Details
I. General information
NPI: 1164425922
Provider Name (Legal Business Name): TRANSCARE MARYLAND, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/24/2005
Last Update Date: 11/20/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1125 DESOTO RD SUITE A
BALTIMORE MD
21223-3222
US
IV. Provider business mailing address
1 METROTECH CTR 20TH FLOOR
BROOKLYN NY
11201-3949
US
V. Phone/Fax
- Phone: 410-242-2279
- Fax: 410-242-9525
- Phone: 718-763-8888
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3416L0300X |
| Taxonomy | Land Ambulance |
| License Number | 586916 |
| License Number State | MD |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3416L0300X |
| Taxonomy | Land Ambulance |
| License Number | 586918 |
| License Number State | MD |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3416L0300X |
| Taxonomy | Land Ambulance |
| License Number | 586917 |
| License Number State | MD |
VIII. Authorized Official
Name: MR.
JAMES
O'CONNOR
Title or Position: PRESIDENT
Credential:
Phone: 718-510-9080