Basic Information
| Provider Information | |||||||||
| NPI: | 1548629900 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | NATIONAL REHABILITATION HOSPITAL, INC. | ||||||||
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| OtherOrganizationName: | MEDSTAR NRH REHAB NETWORK @ LOYOLA UNIVERSITY | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 20410 CENTURY BLVD | ||||||||
| Address2: | SUITE 215 | ||||||||
| City: | GERMANTOWN | ||||||||
| State: | MD | ||||||||
| PostalCode: | 208741186 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3015406140 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4501 N CHARLES ST | ||||||||
| Address2: | DECHIARO COLLEGE CENTER-ROOM 103 | ||||||||
| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212102601 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3015406140 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/15/2016 | ||||||||
| LastUpdateDate: | 02/15/2016 | ||||||||
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| AuthorizedOfficialLastName: | BRICKLEY | ||||||||
| AuthorizedOfficialFirstName: | JOHN | ||||||||
| AuthorizedOfficialMiddleName: | C | ||||||||
| AuthorizedOfficialTitleorPosition: | VICE PRESIDENT AMBULATROY OPERATION | ||||||||
| AuthorizedOfficialTelephone: | 3015406140 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QR0400X | Y | Ambulatory Health Care Facilities | Clinic/Center | Rehabilitation |
No ID Information.