Port Recovery Physicians Care Llc

LBN: Port Recovery Physicians Care Llc
Port Recovery Physicians Care Llc is an health care organization with primary practice located at 8615 Ridgelys Choice Dr Ste 205 , Nottingham MD 21236-3028. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as the primary health care specialty. Port Recovery Physicians Care Llc can be contacted via phone (443) 869-4909, or through Granruth, Joanne via phone (410) 534-8735.

Contact Information

Primary practice address
8615 Ridgelys Choice Dr Ste 205 Nottingham MD 21236-3028
Phone: (443) 869-4909
Fax: (443) 869-4928
Website:
Map and Directions
Authorized official contact:
Name: Granruth, Joanne
Phone: (410) 534-8735

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X

Profile Details

NPI number 1124470356
LBN Legal business name Port Recovery Physicians Care Llc
DBA Doing business as
Authorized official Granruth, Joanne
Entity Organization
Organization subpart 1 No
Enumeration date Jul 12th, 2016
Last updated Nov 15th, 2018 - about 6 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1124470356 NPPES
Maryland MEDICAID 886200100
Maryland Other CP64-0000

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