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General NPI Number Information
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NPI Number | 1699944496
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Entity Type | Organization
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Legal Business Name | HARFORD ON-CALL MEDICAL SERVICES, LLC
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Dates
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Enumeration Date | 02/26/2008
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Last Update Date | 08/04/2008
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Provider Practice Location Address
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Address Line | 2120 EMMORTON PARK RD SUITE E
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City | EDGEWOOD
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State | MD
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Zip | 21040-1066
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Country | US
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Telephone | 410-612-0374
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Fax |
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Provider Business Mailing Address
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Address Line | 2120 EMMORTON PARK RD SUITE E
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City | EDGEWOOD
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State | MD
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Zip | 21040-1066
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Country | US
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Telephone | 410-612-0374
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. THERESA LEWIS
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Credential |
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Telephone | 410-612-0374
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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