Provider Demographics
NPI:1710363122
Name:HOUSE CALLS ON WHEELS
Entity Type:Organization
Organization Name:HOUSE CALLS ON WHEELS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF CLINICAL SERVICES
Authorized Official - Prefix:DR
Authorized Official - First Name:DOROTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:WERE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-200-5042
Mailing Address - Street 1:1801 GLEN KEITH BLVD
Mailing Address - Street 2:
Mailing Address - City:PARKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21234-5100
Mailing Address - Country:US
Mailing Address - Phone:443-979-1446
Mailing Address - Fax:
Practice Address - Street 1:1801 GLEN KEITH BLVD
Practice Address - Street 2:
Practice Address - City:PARKVILLE
Practice Address - State:MD
Practice Address - Zip Code:21234-5100
Practice Address - Country:US
Practice Address - Phone:443-979-1446
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-07
Last Update Date:2015-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR170385363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty