Healthcare Provider Details

I. General information

NPI: 1891706271
Provider Name (Legal Business Name): DIMENSIONS HEALTH CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2006
Last Update Date: 12/07/2020
Certification Date: 12/07/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7300 VAN DUSEN RD
LAUREL MD
20707-9463
US

IV. Provider business mailing address

7300 VAN DUSEN RD
LAUREL MD
20707-9463
US

V. Phone/Fax

Practice location:
  • Phone: 301-725-4300
  • Fax:
Mailing address:
  • Phone: 301-725-4300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number16026
License Number StateMD

VIII. Authorized Official

Name: MR. DOUGLAS SHEPARD
Title or Position: PRESIDENT
Credential:
Phone: 301-497-7974