Provider Demographics
NPI:1699944496
Name:HARFORD ON-CALL MEDICAL SERVICES, LLC
Entity type:Organization
Organization Name:HARFORD ON-CALL MEDICAL SERVICES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-612-0374
Mailing Address - Street 1:2120 EMMORTON PARK RD
Mailing Address - Street 2:SUITE E
Mailing Address - City:EDGEWOOD
Mailing Address - State:MD
Mailing Address - Zip Code:21040-1066
Mailing Address - Country:US
Mailing Address - Phone:410-612-0374
Mailing Address - Fax:
Practice Address - Street 1:2120 EMMORTON PARK RD
Practice Address - Street 2:SUITE E
Practice Address - City:EDGEWOOD
Practice Address - State:MD
Practice Address - Zip Code:21040-1066
Practice Address - Country:US
Practice Address - Phone:410-612-0374
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-26
Last Update Date:2008-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty