Provider Demographics
NPI:1811409717
Name:ANKH REJUVENATION, INC.
Entity Type:Organization
Organization Name:ANKH REJUVENATION, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:E
Authorized Official - Last Name:GAINER
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:240-344-7784
Mailing Address - Street 1:6011 OFFSHORE GRN
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21045-3822
Mailing Address - Country:US
Mailing Address - Phone:240-344-7784
Mailing Address - Fax:
Practice Address - Street 1:8775 CENTRE PARK DR STE 423
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-2177
Practice Address - Country:US
Practice Address - Phone:240-344-7784
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-01
Last Update Date:2017-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy AssistantGroup - Multi-Specialty
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty