Healthcare Provider Details

I. General information

NPI: 1477329316
Provider Name (Legal Business Name): THE AUGANICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2023
Last Update Date: 12/10/2023
Certification Date: 12/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3605 COURTLEIGH DR
RANDALLSTOWN MD
21133-4806
US

IV. Provider business mailing address

3605 COURTLEIGH DR
RANDALLSTOWN MD
21133-4806
US

V. Phone/Fax

Practice location:
  • Phone: 443-788-4885
  • Fax:
Mailing address:
  • Phone: 443-788-4885
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code175L00000X
TaxonomyHomeopath
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code405300000X
TaxonomyPrevention Professional
License Number
License Number State

VIII. Authorized Official

Name: AUDRA BENEE TRAVERS
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 443-379-3888