Organization
REMEDIUM ANCILLARY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HANS PRINCE DOHERTY (CEO)
(443) 240-7072
Entity
Organization
Contact information
Practice address
10203 GRANDHAVEN AVE # 115, UPPER MARLBORO, MD 20772-6656
(443) 240-7072
Mailing address
10203 GRANDHAVEN AVE # 115, UPPER MARLBORO, MD 20772-6656
(443) 240-7072
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
—
—
163WC1500X
Community Health Registered Nurse
—
—
163WC2100X
Continence Care Registered Nurse
—
—
164W00000X
Licensed Practical Nurse
—
—
164X00000X
Licensed Vocational Nurse
—
—
167G00000X
Licensed Psychiatric Technician
—
—
Other
Enumeration date
07/26/2023
Last updated
07/27/2023
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