Provider Demographics
NPI:1528615879
Name:WILTSHIRE'S, INC
Entity type:Organization
Organization Name:WILTSHIRE'S, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DERVENT
Authorized Official - Middle Name:C
Authorized Official - Last Name:WILTSHIRE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:240-575-0609
Mailing Address - Street 1:174 THOMAS JOHNSON DR # 203L
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21702-4423
Mailing Address - Country:US
Mailing Address - Phone:240-651-3485
Mailing Address - Fax:240-358-0696
Practice Address - Street 1:174 THOMAS JOHNSON DR # 203L
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21702-4423
Practice Address - Country:US
Practice Address - Phone:240-651-3485
Practice Address - Fax:240-358-0696
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-21
Last Update Date:2019-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care