=====================================================
General NPI Number Information
=====================================================
NPI Number | 1295106920
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DR. RITA A AMACHREE
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/07/2015
-----------------------------------------------------
Last Update Date | 10/07/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9804 PHEASANT RUN CT
-----------------------------------------------------
City | LAUREL
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 20708-3192
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 202-320-8402
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9804 PHEASANT RUN CT
-----------------------------------------------------
City | LAUREL
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 20708-3192
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 202-320-8402
-----------------------------------------------------
Fax | 301-477-1336
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251J00000X
-----------------------------------------------------
Taxonomy Name | Nursing Care Agency
-----------------------------------------------------
License Number | HCSA1308003
-----------------------------------------------------
License Number State | MD
-----------------------------------------------------