Provider Demographics
NPI:1982228045
Name:PATAPSCO HEALTH & REHAB LLC
Entity Type:Organization
Organization Name:PATAPSCO HEALTH & REHAB LLC
Other - Org Name:PATAPSCO INTEGRATIVE MEDICINE & REHAB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING EMPLOYEE W-2
Authorized Official - Prefix:
Authorized Official - First Name:JAMIEL
Authorized Official - Middle Name:SHARIEF
Authorized Official - Last Name:HAFIZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-227-4939
Mailing Address - Street 1:14 STONE SPRING CT
Mailing Address - Street 2:
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-5367
Mailing Address - Country:US
Mailing Address - Phone:410-227-4939
Mailing Address - Fax:769-201-0777
Practice Address - Street 1:8975 GUILFORD RD STE 170
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21046-2389
Practice Address - Country:US
Practice Address - Phone:410-705-5541
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-04
Last Update Date:2023-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Multi-Specialty
No335E00000XSuppliersProsthetic/Orthotic Supplier