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PEACE & GLORY MANOR, INC

Laboratories Clinical Medical Laboratory

Provider NPI: 1003149733

Organization Information:
Organization Name:  PEACE & GLORY MANOR, INC
Organization is not Subpart
Authorized Official:  GLORIA LYNN BROWN - BRISTOL  OWNER  443-386-9959

Practice Location:
3829 KILBURN RD  RANDALLSTOWN, MD 21133-4655 US
Tel: 443-386-9959  Fax: 410-922-4620

Business Mailing Address:
3829 KILBURN RD  RANDALLSTOWN, MD 21133-4655 US
Tel: 443-386-9959  Fax: 410-922-4620

NPI Information:
NPI: 1003149733
Entity Type: Organization

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N291U00000XLaboratories
Clinical Medical Laboratory
N305R00000XManaged Care Organizations
Preferred Provider Organization
N320700000XResidential Treatment Facilities
Residential Treatment Facility, Physical Disabilities
N332BC3200XSuppliers
Durable Medical Equipment & Medical Supplies
N332BN1400XSuppliers
Durable Medical Equipment & Medical Supplies
N332BP3500XSuppliers
Durable Medical Equipment & Medical Supplies
N332S00000XSuppliers
Hearing Aid Equipment
N343900000XTransportation Services
Non-emergency Medical Transport (VAN)
N347C00000XTransportation Services
Private Vehicle
Y343800000XTransportation Services
Secured Medical Transport (VAN)

Other Provider Identifiers:

IssuerNumberStateType



American Medical Association 2012 taxonomy code information

Code: 343800000X

Type:

Classification:



Definition:



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