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MARYLAND HEALTHCARE SERVICES INC NPI 1811194061


NPI Information

NPI: 1811194061
Provider Name: MARYLAND HEALTHCARE SERVICES INC

Doing Business As: REVIVAL HOMECARE AGENCY

Classification: Home Health - 251E00000X
Entity Type: Organization

CLIA Number: 21D2139244

Address:
1101 MERCANTILE LN
SUITE 292
UPPER MARLBORO, MD
ZIP 20774
Phone: (888) 225-6994
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MARYLAND HEALTHCARE SERVICES INC is a home health in Upper Marlboro, MD. The provider is a public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety. MARYLAND HEALTHCARE SERVICES INC NPI is 1811194061. The provider is registered as an organization entity type.
The provider Is Doing Business As Revival Homecare Agency.

The provider's business location address is:

1101 MERCANTILE LN
SUITE 292
UPPER MARLBORO, MD
ZIP 20774-360
Phone: (888) 225-6994
Fax: (888) 592-3644

The provider's authorized official is Akram Elzend .
The authorized official title is Chief Executive Officer and has the following contact phone number (888) 225-6994.

The CLIA number assigned to this NPI record is 21D2139244 - home health agency with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/29/2007 and was last updated on 10/2/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1251E00000XHome HealthHH7047MARYLANDYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1414786300MEDICAIDMARYLAND
2HCO-512309OTHERMARYLANDJOINT COMMISSION
3HCA-0109OTHERDISTRICT OF COLUMBIAHOME CARE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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