MEDICARE: BEDICLN

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
1	311ZA0620X	Adult Care Home Facility	R17044	MD

General Provider Information

NPI Number	:	1538563481
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BEDICLN

Provider Business Mailing Address
First Line	:	2 TROUT LILY CT
Second Line	:
City	:	OWINGS MILLS
State	:	MD
Zip	:	21117-4875
Country	:	US
Telephone Number	:	443-641-3906
Fax Number	:

Provider Business Practice Location Address
First Line	:	2 TROUT LILY CT
Second Line	:
City	:	OWINGS MILLS
State	:	MD
Zip	:	21117-4875
Country	:	US
Telephone Number	:	443-641-3906
Fax Number	:

Authorized Official
Title or Position	:	NURSE
Name	:	ALICE J BEDI
Credential	:	RN
Telephone Number	:	443-641-3906

Provider Enumeration Date	:	10/21/2014
Last Update Date	:	10/21/2014

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