Organization
ESSENTIAL REHAB PLUS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CORTLAND DERIC BARD (OWNER)
(301) 516-9600
Entity
Organization
Contact information
Practice address
8033 PENN RANDALL PL, UPPER MARLBORO, MD 20772-2648
(301) 516-9600
(301) 516-0900
Mailing address
8033 PENN RANDALL PL, UPPER MARLBORO, MD 20772-2648
(301) 516-9600
(301) 516-0900
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
10636048
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9120611
—
VA
Enumeration date
03/07/2006
Last updated
08/22/2020
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