MEDICARE: RITA TEH

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	374U00000X	Home Health Aide

General Provider Information

NPI Number	:	1619359825
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RITA TEH

Provider Business Mailing Address
First Line	:	3366 CHILLUM RD
Second Line	:
City	:	MOUNT RAINIER
State	:	MD
Zip	:	20712-1145
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3366 CHILLUM RD
Second Line	:
City	:	MOUNT RAINIER
State	:	MD
Zip	:	20712-1145
Country	:	US
Telephone Number	:	240-705-5325
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/24/2015
Last Update Date	:	06/24/2015

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Directions to “ RITA TEH ” Practice Location

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