Healthcare Provider Details

I. General information

NPI: 1578293825
Provider Name (Legal Business Name): BLS DIAGNOSTICS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2022
Last Update Date: 03/25/2026
Certification Date: 03/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8894 STANFORD BLVD STE 104
COLUMBIA MD
21045-5161
US

IV. Provider business mailing address

2012 S TOLLGATE RD STE 100
BEL AIR MD
21015-5901
US

V. Phone/Fax

Practice location:
  • Phone: 866-526-8088
  • Fax:
Mailing address:
  • Phone: 866-526-8088
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2251E1300X
TaxonomyClinical Electrophysiology Physical Therapist
License Number
License Number State

VIII. Authorized Official

Name: MELISSA CATHERINE MCCARTHY
Title or Position: BILLING SPECIALIST
Credential:
Phone: 443-595-4441