Provider Demographics
NPI:1518623305
Name:ON CALL HEALTHCARE LLC
Entity Type:Organization
Organization Name:ON CALL HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:IDETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:BRUMBAUGH
Authorized Official - Suffix:
Authorized Official - Credentials:RN, CWCA
Authorized Official - Phone:410-991-9079
Mailing Address - Street 1:30 SHELLDRAKE CT
Mailing Address - Street 2:
Mailing Address - City:DAMASCUS
Mailing Address - State:MD
Mailing Address - Zip Code:20872-2614
Mailing Address - Country:US
Mailing Address - Phone:410-991-9079
Mailing Address - Fax:301-253-5174
Practice Address - Street 1:30 SHELLDRAKE CT
Practice Address - Street 2:
Practice Address - City:DAMASCUS
Practice Address - State:MD
Practice Address - Zip Code:20872-2614
Practice Address - Country:US
Practice Address - Phone:410-991-9079
Practice Address - Fax:301-253-5174
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-16
Last Update Date:2021-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Single Specialty
No163WC0400XNursing Service ProvidersRegistered NurseCase ManagementGroup - Single Specialty
No163WW0000XNursing Service ProvidersRegistered NurseWound CareGroup - Single Specialty