1073198420 NPI number — ERICCA LOREINE BLAKE MORGAN

Table of content: ERICCA LOREINE BLAKE MORGAN (NPI 1073198420)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1073198420 NPI number — ERICCA LOREINE BLAKE MORGAN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BLAKE MORGAN
Provider First Name:
ERICCA
Provider Middle Name:
LOREINE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
F

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:
1073198420
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/16/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
BEYOND CARE STAFFING & HEALTH SERVICES, LLC
Provider Second Line Business Mailing Address:
8 BLUE SKY DRIVE
Provider Business Mailing Address City Name:
OWINGS MILLS, MD
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21117-0741
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-572-7880
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
BEYOND CARE STAFFING & HEALTH SERVICES
Provider Second Line Business Practice Location Address:
8 BLUE SKY DRIVE
Provider Business Practice Location Address City Name:
OWINGS MILLS, MD
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21117
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-572-7880
Provider Business Practice Location Address Fax Number:
410-363-1369
Provider Enumeration Date:
03/16/2021

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 376K00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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