Provider Demographics
NPI:1972626968
Name:ACUPUNCTURE, INC.
Entity type:Organization
Organization Name:ACUPUNCTURE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:RUTH
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:LICAC
Authorized Official - Phone:410-740-1750
Mailing Address - Street 1:4964 WOODWARD GDNS
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21044-1525
Mailing Address - Country:US
Mailing Address - Phone:410-740-1750
Mailing Address - Fax:410-740-4330
Practice Address - Street 1:4964 WOODWARD GDNS
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044-1525
Practice Address - Country:US
Practice Address - Phone:410-740-1750
Practice Address - Fax:410-740-4330
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU00736171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDLU81OtherCAREFIRST BC BS
DCS225-0001OtherCAREFIRST BC BS