Provider Demographics
NPI:1740937366
Name:OUR FAMILY HEALTHCARE
Entity type:Organization
Organization Name:OUR FAMILY HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:
Authorized Official - Last Name:DIRICKSON-FORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-542-8812
Mailing Address - Street 1:1576 MERRITT BLVD
Mailing Address - Street 2:SUITE 15
Mailing Address - City:DUNDALK
Mailing Address - State:MD
Mailing Address - Zip Code:21222-2114
Mailing Address - Country:US
Mailing Address - Phone:443-530-6165
Mailing Address - Fax:
Practice Address - Street 1:1576 MERRITT BLVD
Practice Address - Street 2:SUITE 15
Practice Address - City:DUNDALK
Practice Address - State:MD
Practice Address - Zip Code:21222-2114
Practice Address - Country:US
Practice Address - Phone:443-530-6165
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-03
Last Update Date:2023-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty