Organization
PHR OF MARYLAND, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN CLEMENS (DIRECTOR OF FINANCE)
(703) 752-8710
Entity
Organization
Contact information
Practice address
4429 FORBES BLVD, LANHAM, MD 20706-4328
(301) 552-8325
(301) 552-2734
Mailing address
7619 LITTLE RIVER TPKE, SUITE 600, ANNANDALE, VA 22003-2625
(703) 752-8700
(703) 752-8719
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
HH7120
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
402109600
—
MD
Enumeration date
03/19/2007
Last updated
12/15/2008
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