MEDICARE: ROLAK GROUP INC

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	251J00000X	Nursing Care Agency	R2228	MD

General Provider Information

NPI Number	:	1770603631
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROLAK GROUP INC

Provider Business Mailing Address
First Line	:	3610 MILFORD MILL RD
Second Line	:	SUITE T-4
City	:	BALTIMORE
State	:	MD
Zip	:	21244-3330
Country	:	US
Telephone Number	:	410-655-1202
Fax Number	:

Provider Business Practice Location Address
First Line	:	3610 MILFORD MILL RD
Second Line	:	SUITE T-4
City	:	BALTIMORE
State	:	MD
Zip	:	21244-3330
Country	:	US
Telephone Number	:	410-655-1202
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	QUADRI OLABODE JOHNSON
Credential	:
Telephone Number	:	410-655-1202

Provider Enumeration Date	:	04/01/2007
Last Update Date	:	08/22/2020

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