Organization
USA REHAB
Active
Organization
USA REHAB
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ERIC ANDERSON (OWNER)
(410) 653-3903
Entity
Organization
Contact information
Practice address
104 CHURCH LN # 107, BALTIMORE, MD 21208-3786
(410) 653-3903
Mailing address
104 CHURCH LN # 107, BALTIMORE, MD 21208-3786
(410) 653-3903
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
520022900
—
MD
Enumeration date
12/20/2005
Last updated
02/03/2016
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