1487019915 NPI number — ADVENTIST REHABILITATION HOSPITAL OF MARYLAND, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487019915 NPI number — ADVENTIST REHABILITATION HOSPITAL OF MARYLAND, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ADVENTIST REHABILITATION HOSPITAL OF MARYLAND, INC.
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:
ADVENTIST HEALTHCARE REHABILITATION
Provider Other Organization Name Type Code:
3
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:
1487019915
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/22/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
820 W DIAMOND AVE
Provider Second Line Business Mailing Address:
SUITE 500
Provider Business Mailing Address City Name:
GAITHERSBURG
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20878-1419
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-315-3176
Provider Business Mailing Address Fax Number:
301-315-3728

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
831 UNIVERSITY BLVD E
Provider Second Line Business Practice Location Address:
SUITE 14
Provider Business Practice Location Address City Name:
SILVER SPRING
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20903-2916
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-445-3191
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/29/2015

Additional Information

Authorized Official

Authorized Official Last Name:
LEE
Authorized Official First Name:
JAMES
Authorized Official Middle Name:
Authorized Official Title or Position:
SECRETARY & TREASURER
Authorized Official Telephone Number:
301-315-3030

Provider Taxonomy Codes

  • Taxonomy code: 261QR0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 407075500 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".




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