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General NPI Number Information
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NPI Number | 1891613451
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Entity Type | Organization
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Legal Business Name | TRUE LTC 104 LLC
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Dates
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Enumeration Date | 07/09/2026
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Last Update Date | 07/09/2026
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Provider Practice Location Address
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Address Line | 187 HOSPITAL DR
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City | TYRONE
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State | PA
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Zip | 16686-1808
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Country | US
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Telephone | 443-465-8088
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Fax |
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Provider Business Mailing Address
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Address Line | 15 TREMBLANT CT
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City | LUTHERVILLE TIMONIUM
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State | MD
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Zip | 21093-3747
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Country | US
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Telephone | 443-465-8088
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Fax |
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Authorized Official
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Title or Position | SENIOR DIRECTOR OF OPERATIONS
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Name | JILL C FORD
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Credential |
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Telephone | 484-643-2629
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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