Provider Demographics
NPI:1942613120
Name:MEDIFLAIR, LLC
Entity Type:Organization
Organization Name:MEDIFLAIR, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:LIGHTNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:877-439-5856
Mailing Address - Street 1:204 E JOPPA RD
Mailing Address - Street 2:SUITE L03
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21286-3118
Mailing Address - Country:US
Mailing Address - Phone:877-439-5856
Mailing Address - Fax:443-378-8733
Practice Address - Street 1:204 E JOPPA RD
Practice Address - Street 2:SUITE L03
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21286-3118
Practice Address - Country:US
Practice Address - Phone:877-439-5856
Practice Address - Fax:443-378-8733
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-05
Last Update Date:2014-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD1309023251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care