Provider Demographics
NPI:1699868349
Name:RESTORATIVE THERAPIES, INC
Entity type:Organization
Organization Name:RESTORATIVE THERAPIES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JIM
Authorized Official - Middle Name:
Authorized Official - Last Name:JANICKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-609-9166
Mailing Address - Street 1:8098 SANDPIPER CIR STE M
Mailing Address - Street 2:
Mailing Address - City:NOTTINGHAM
Mailing Address - State:MD
Mailing Address - Zip Code:21236-4928
Mailing Address - Country:US
Mailing Address - Phone:800-609-9166
Mailing Address - Fax:443-835-4947
Practice Address - Street 1:8098 SANDPIPER CIR STE M
Practice Address - Street 2:
Practice Address - City:NOTTINGHAM
Practice Address - State:MD
Practice Address - Zip Code:21236-4928
Practice Address - Country:US
Practice Address - Phone:800-609-9166
Practice Address - Fax:410-878-2466
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2022-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ-----------------Medicaid
....................OtherDEPARTMENT OF VETERANS AFFAIRS - CONTRACT AWARDED
OR....................Medicaid
IL....................Medicaid
MD....................OtherMARYLAND RESIDENTIAL SERVICE AGENCY LICENSE FOR DURABLE MEDICAL EQUIPMENT
VA....................Medicaid
NM....................Medicaid