Provider Demographics
NPI:1144561663
Name:DEFYD SERVICES LLC
Entity Type:Organization
Organization Name:DEFYD SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:HARRISON
Authorized Official - Last Name:FEDDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-262-1228
Mailing Address - Street 1:8902 MERRILL LN
Mailing Address - Street 2:SUITE 302
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20708-2024
Mailing Address - Country:US
Mailing Address - Phone:410-262-1228
Mailing Address - Fax:
Practice Address - Street 1:8902 MERRILL LN
Practice Address - Street 2:SUITE 302
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20708-2024
Practice Address - Country:US
Practice Address - Phone:410-262-1228
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-07
Last Update Date:2013-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR3371251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health