Healthcare Provider Details

I. General information

NPI: 1013796390
Provider Name (Legal Business Name): PHO- VITAL SIGNS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2023
Last Update Date: 09/26/2023
Certification Date: 09/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1615 YORK RD STE 201
LUTHERVILLE MD
21093-5616
US

IV. Provider business mailing address

1615 YORK RD STE 201
LUTHERVILLE MD
21093-5616
US

V. Phone/Fax

Practice location:
  • Phone: 410-814-0258
  • Fax: 410-814-0326
Mailing address:
  • Phone: 443-983-1188
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number
License Number StateNULL
# 5
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: VENUS RICKS
Title or Position: OWNER/DIRECTOR OF NURSE
Credential: REGISTERED NURSE
Phone: 443-983-1188