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NPI Code Detail

MEDICARE: ROARK LLC

MEDICARE: ROARK LLC
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
1302R00000XHealth Maintenance Organization

General Provider Information

NPI Number : 1427358175
Entity Type Code : Organization
Provider Name (Legal Business Name) : ROARK LLC
Provider Business Mailing Address
First Line : 2310 RHODE ISLAND AVE
Second Line :
City : WASHINGTON
State : DC
Zip : 20018
Country : US
Telephone Number : 202-529-4404
Fax Number :
Provider Business Practice Location Address
First Line : 2310 RHODE ISLAND AVE NE
Second Line :
City : WASHINGTON
State : DC
Zip : 20018-2829
Country : US
Telephone Number : 202-529-4404
Fax Number :
Authorized Official
Title or Position : MEMBER OF LLC
Name : MR. JOSEPH ANTHONY SUFCZYNSKI JR.
Credential :
Telephone Number : 202-529-4404
Provider Enumeration Date : 10/28/2010
Last Update Date : 10/28/2010

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Directions to “ROARK LLC ” Practice Location

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