Healthcare Provider Details

I. General information

NPI: 1295596815
Provider Name (Legal Business Name): 1821 FREIGHT, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2024
Last Update Date: 01/22/2024
Certification Date: 01/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9102 HELMSLEY DR STE G
CLINTON MD
20735-2937
US

IV. Provider business mailing address

8861 BRANCH AVE # 1001
CLINTON MD
20735-2632
US

V. Phone/Fax

Practice location:
  • Phone: 240-478-1820
  • Fax: 301-235-3171
Mailing address:
  • Phone: 240-478-1820
  • Fax: 301-235-3171

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code347E00000X
TaxonomyTransportation Broker
License Number
License Number State

VIII. Authorized Official

Name: MRS. KIM THROWER
Title or Position: PRESIDENT
Credential:
Phone: 240-478-1820