=====================================================
General NPI Number Information
=====================================================
NPI Number | 1962359679
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BAKARIKA CORP
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/12/2026
-----------------------------------------------------
Last Update Date | 03/12/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 10711 RED RUN BLVD STE 101
-----------------------------------------------------
City | OWINGS MILLS
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21117-5138
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 443-883-8634
-----------------------------------------------------
Fax | 240-565-0741
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 10711 RED RUN BLVD STE 101
-----------------------------------------------------
City | OWINGS MILLS
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21117-5138
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 443-883-8634
-----------------------------------------------------
Fax | 240-565-0741
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | BAKARI CHAKHMAKHASHVILI
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 443-883-8634
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QA1903X
-----------------------------------------------------
Taxonomy Name | Ambulatory Surgical Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------