Healthcare Provider Details

I. General information

NPI: 1073397824
Provider Name (Legal Business Name): RIGHTEOUS TRACK, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2023
Last Update Date: 08/22/2023
Certification Date: 08/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8604 CENTRAL AVE STE 3
HYATTSVILLE MD
20785-4819
US

IV. Provider business mailing address

5507 ROSECROFT VILLAGE DR
OXON HILL MD
20745-3646
US

V. Phone/Fax

Practice location:
  • Phone: 202-441-2261
  • Fax:
Mailing address:
  • Phone: 202-441-2261
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: MS. LORI A DONOHO
Title or Position: OWNER
Credential: HAIR LOSS SPECIALIST
Phone: 202-441-2261