Healthcare Provider Details

I. General information

NPI: 1225973027
Provider Name (Legal Business Name): ROOTED IN DEEP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2026
Last Update Date: 04/20/2026
Certification Date: 04/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3905 SADIE RD
RANDALLSTOWN MD
21133-4010
US

IV. Provider business mailing address

3905 SADIE RD
RANDALLSTOWN MD
21133-4010
US

V. Phone/Fax

Practice location:
  • Phone: 443-675-2184
  • Fax:
Mailing address:
  • Phone: 443-675-2184
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343800000X
TaxonomySecured Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: CORAL VERONA ROSS
Title or Position: CEO
Credential:
Phone: 410-491-1917