Provider Demographics
NPI:1295546075
Name:ERICKA MONIQUE RICHARDSON
Entity type:Organization
Organization Name:ERICKA MONIQUE RICHARDSON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ERICKA
Authorized Official - Middle Name:MONIQUE
Authorized Official - Last Name:RICHARDSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-687-5041
Mailing Address - Street 1:6005 PLUMER AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21206-2760
Mailing Address - Country:US
Mailing Address - Phone:443-687-5041
Mailing Address - Fax:
Practice Address - Street 1:8815 PULASKI HWY
Practice Address - Street 2:
Practice Address - City:ROSEDALE
Practice Address - State:MD
Practice Address - Zip Code:21237-3010
Practice Address - Country:US
Practice Address - Phone:443-687-5041
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-20
Last Update Date:2025-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment