1770274383 NPI number — ELITE PRO HOME HEALTH

Table of content: ROHAN RAJNIKANT PATEL DO (NPI 1851929731)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1770274383 NPI number — ELITE PRO HOME HEALTH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ELITE PRO HOME HEALTH
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:
1770274383
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/16/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9606 WESTERDALE DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
UPPER MARLBORO
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20774-2461
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3406 SAVILLE LN
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BOWIE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20721-4035
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
216-789-0509
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/16/2023

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
BLACKWELL
Authorized Official First Name:
LAVELLE
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO/OCCUPATIONAL THERAPIST
Authorized Official Telephone Number:
216-789-0509

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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