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General NPI Number Information
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NPI Number | 1447635073
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Entity Type | Organization
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Legal Business Name | EASTERN SHORE LOV'N CARE LLC
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Dates
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Enumeration Date | 07/24/2015
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Last Update Date | 07/24/2015
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Provider Practice Location Address
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Address Line | 30331 OAK ST
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City | PRINCESS ANNE
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State | MD
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Zip | 21853-1333
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Country | US
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Telephone | 410-651-3066
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Fax |
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Provider Business Mailing Address
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Address Line | 30331 OAK ST
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City | PRINCESS ANNE
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State | MD
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Zip | 21853-1333
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Country | US
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Telephone | 410-651-3066
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | MR. EVERETT R. NOBLE
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Credential |
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Telephone | 410-651-3066
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | R2247
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License Number State | MD
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