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General NPI Number Information
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NPI Number | 1861023525
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Entity Type | Organization
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Legal Business Name | HOME CARE MEDICAL, LLC
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Dates
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Enumeration Date | 01/31/2020
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Last Update Date | 01/31/2020
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Provider Practice Location Address
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Address Line | 8407 MAIN ST
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City | ELLICOTT CITY
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State | MD
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Zip | 21043-4867
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Country | US
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Telephone | 410-715-1978
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Fax |
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Provider Business Mailing Address
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Address Line | 8407 MAIN ST
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City | ELLICOTT CITY
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State | MD
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Zip | 21043-4867
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Country | US
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Telephone | 410-715-1978
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DITTA ALLEN
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Credential | MSN, MSJ, CRNP
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Telephone | 410-715-1978
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number |
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License Number State |
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