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NPI Code Detail

MEDICARE: RICK BRISCOE

MEDICARE: RICK BRISCOE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1374U00000XHome Health Aide

General Provider Information

NPI Number : 1205437670
Entity Type Code : Individual
Provider Name (Legal Business Name) : RICK BRISCOE
Provider Business Mailing Address
First Line : 11300 KETTERING WAY
Second Line :
City : UPPER MARLBORO
State : MD
Zip : 20774-1554
Country : US
Telephone Number : 301-665-6353
Fax Number :
Provider Business Practice Location Address
First Line : 3298 FORT LINCOLN DR NE APT 1010
Second Line :
City : WASHINGTON
State : DC
Zip : 20018-4342
Country : US
Telephone Number : 202-709-2607
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/03/2020
Last Update Date : 11/03/2020

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