Provider Demographics
NPI:1427358175
Name:ROARK LLC
Entity Type:Organization
Organization Name:ROARK LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER OF LLC
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:SUFCZYNSKI
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:202-529-4404
Mailing Address - Street 1:2310 RHODE ISLAND AVE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20018
Mailing Address - Country:US
Mailing Address - Phone:202-529-4404
Mailing Address - Fax:
Practice Address - Street 1:2310 RHODE ISLAND AVE NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20018-2829
Practice Address - Country:US
Practice Address - Phone:202-529-4404
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-28
Last Update Date:2010-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization