1255331500 NPI number — ON Q NURSING SERVICES L.L.C.

Table of content: (NPI 1255331500)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1255331500 NPI number — ON Q NURSING SERVICES L.L.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ON Q NURSING SERVICES L.L.C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1255331500
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
139 N MAIN ST
Provider Second Line Business Mailing Address:
SUITE 308
Provider Business Mailing Address City Name:
BEL AIR
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21014-8843
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-879-0005
Provider Business Mailing Address Fax Number:
410-420-2266

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
139 N MAIN ST
Provider Second Line Business Practice Location Address:
SUITE 308
Provider Business Practice Location Address City Name:
BEL AIR
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21014-8843
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-879-0005
Provider Business Practice Location Address Fax Number:
410-420-2266
Provider Enumeration Date:
07/28/2005

Additional Information

Authorized Official

Authorized Official Last Name:
LOPEZ
Authorized Official First Name:
QUERIDA
Authorized Official Middle Name:
LYNNE
Authorized Official Title or Position:
CEO/COO
Authorized Official Telephone Number:
410-879-0005

Provider Taxonomy Codes

  • Taxonomy code: 251J00000X , with the licence number:  R2085 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: V512(P)P-762 . This is a "DEPT. OF VETERANS AFFAIRS" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 000583 . This is a "HARFORD CTY OFF ON AGING" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".




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