LIFEBRIDGE SPORTS MEDICINE AND REHABILITATION LLC (NPI# 1215421532) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215421532 |
| Entity Type | Organization |
| Organization Name | LIFEBRIDGE SPORTS MEDICINE AND REHABILITATION LLC |
| Practice Address |
1393 Progress Way Ste 907 Eldersburg MD 21784-6473 |
| Mailing Address |
4714 Gettysburg Rd Mechanicsburg PA 17055-4325 |
| Practice Telephone | 4105494960 |
| Enumeration Date | 2018-06-20 |
| Last Update Date | 2018-06-20 |
| Authorized Official Name | MICHAEL E TARVIN (VICE PRESIDENT) |
| Authorized Official Telephone | 7179721100 |
| Is Organization Subpart | Y |
| Parent Organization Name | LIFEBRIDGE SPORTS MEDICINE AND REHABILITATION LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154931962 | Lifebridge Sports Medicine and Rehabilitation LLC | Clinic/Center | 41 Magna Way Ste 140, Westminster, MD 21157-3073 | 2020-08-06 |
| 1770059701 | Lifebridge Sports Medicine and Rehabilitation LLC | Occupational Therapist | 19 Walker Ave Ste 100, Pikesville, MD 21208-4006 | 2018-10-17 |
| 1992271902 | Lifebridge Sports Medicine and Rehabilitation LLC | Clinic/Center | 8114 Sandpiper Cir Ste 114, Baltimore, MD 21236-5901 | 2018-10-17 |
| 1932592151 | Lifebridge Sports Medicine and Rehabilitation LLC | Clinic/Center | 1167 Merritt Blvd, Store #1167 C-2, Dundalk, MD 21222-1438 | 2015-03-12 |
| 1255941522 | Lifebridge Sports Medicine and Rehabilitation LLC | Clinic/Center | 6190 Georgetown Blvd, Eldersburg, MD 21784-6460 | 2020-08-03 |
| 1578198339 | Lifebridge Sports Medicine and Rehabilitation LLC | Clinic/Center | 1836 Greene Tree Rd, Baltimore, MD 21208-1381 | 2020-03-11 |
| 1487289245 | Lifebridge Sports Medicine and Rehabilitation LLC | Clinic/Center | 1364 Martin Blvd Ste 5, Middle River, MD 21220-4104 | 2020-03-11 |
| 1487289781 | Lifebridge Sports Medicine and Rehabilitation LLC | Clinic/Center | 8114 Sandpiper Cir Ste 114, Baltimore, MD 21236-5901 | 2020-03-06 |
| 1033755434 | Lifebridge Sports Medicine and Rehabilitation LLC | Clinic/Center | 6190 Georgetown Blvd, Eldersburg, MD 21784-6460 | 2019-11-20 |
| 1326699919 | Lifebridge Sports Medicine and Rehabilitation LLC | Clinic/Center | 1011 Baltimore Blvd, Westminster, MD 21157-7055 | 2019-09-25 |
| Street Address |
1393 PROGRESS WAY STE 907 |
| City | ELDERSBURG |
| State | MD |
| Zip Code | 21784-6473 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962978999 | Lifebridge Sports Medicine and Rehabilitation LLC | Occupational Therapist | 1393 Progress Way Ste 907, Eldersburg, MD 21784-6473 | 2018-10-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033681085 | Kathleen Busching | Occupational Therapy Assistant | Intergrace Fairhaven, 7200 Third Ave, Sykesville, MD 21784 | 2018-12-31 |
| 1619450376 | Mackenzie Fleming | Counselor | 6220 Georgetown Blvd Suite C, Eldersburg, MD 21784 | 2018-09-10 |
| 1316426919 | Rebecca Rubin | Nurse Practitioner | 1380 Progress Way, Suite 102, Eldersburg, MD 21784 | 2018-08-14 |
| 1417473273 | Andrey Doroshenko | Dentist | 1722 Underwood Road, Sykesville, MD 21784 | 2017-08-14 |
| 1992229694 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 6400 Georgetown Blvd, Eldersburg, MD 21784 | 2017-08-03 |
| 1457894495 | Bethany Six | Nurse Practitioner | 6190 Gerogetown Blvd, Eldersburg, MD 21784 | 2016-11-23 |
| 1982011821 | Fast Track Urgent Care, LLC | Clinic/Center | 1315 Breton Drive, Eldersburg, MD 21784 | 2014-07-11 |
| 1588097984 | Centers for Advanced Orthopaedics, LLC | Orthopaedic Surgery | 5961 Exchange Dr, Suite 100, Eldersburg, MD 21784 | 2013-08-21 |
| 1356690986 | Kayla Nicole Koster | Speech-Language Pathologist | 1702 Liberty Road, First Floor, Sykesville, MD 21784 | 2012-08-29 |
| 1558645663 | Fusion Dental | Dentist | 5959 Exchange Drive, Suite 116, Eldersburg, MD 21784 | 2011-10-07 |
| Find all providers in zip 21784 | ||||
| Taxonomy Code | 332B00000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient’s use in the home and that are usable for an extended period of time. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992229694 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 6400 Georgetown Blvd, Eldersburg, MD 21784 | 2017-08-03 |
| 1659568525 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 1260 Liberty Rd, Eldersburg, MD 21784-7928 | 2007-09-25 |
| 1447456181 | Chesapeake Urology Associates P.a. | Durable Medical Equipment & Medical Supplies | 6109 Georgetown Blvd, Eldersburg, MD 21784 | 2007-06-21 |
| 1093824468 | Rite Aid of Maryland Inc | Durable Medical Equipment & Medical Supplies | 6300 Georgetown Boulevard 107, Freedom Village Shopping Center, Eldersburg, MD 21784-6481 | 2006-08-30 |
| 1780613703 | Nai Saturn Eastern LLC | Durable Medical Equipment & Medical Supplies | 1313 Londontown Blvd, Eldersburg, MD 21784-6409 | 2006-07-02 |
| 1831700202 | Nai Saturn Eastern LLC | Durable Medical Equipment & Medical Supplies | 1313 Londontown Blvd, Eldersburg, MD 21784-6409 | 2020-08-11 |
| 1225233315 | Chesapeake Urology Associates P.a. | Durable Medical Equipment & Medical Supplies | 1645 Liberty Rd, Eldersburg, MD 21784-6521 | 2007-06-19 |
| 1952349748 | Choice Medical Supply Company | Durable Medical Equipment & Medical Supplies | 1311 Londontown Blvd, Suite 130, Eldersburg, MD 21784-6454 | 2006-06-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528669652 | The Grab Bar, LLC | Durable Medical Equipment & Medical Supplies | 11 Huntington Pl, Bel Air, MD 21014-5307 | 2020-11-04 |
| 1659971711 | Montpelier Family Dentistry LLC | Durable Medical Equipment & Medical Supplies | 14502 Greenview Dr Ste 100, Laurel, MD 20708-3221 | 2020-10-28 |
| 1316546021 | Medibuy Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 12826 Forest Creek Ct, Sykesville, MD 21784-5526 | 2020-10-22 |
| 1295334571 | Coastline Medical LLC | Durable Medical Equipment & Medical Supplies | 9928 Old Ocean City Blvd Ste 10, Berlin, MD 21811-1170 | 2020-10-19 |
| 1013515154 | Ls Creative Agency LLC | Durable Medical Equipment & Medical Supplies | 1153 Route 3 North, Suite 10, Gambrills, MD 21054 | 2020-10-12 |
| 1487261202 | Hanger Prosthetics & Orthotics Inc | Durable Medical Equipment & Medical Supplies | 4601 Presidents Dr Ste 320, Lanham, MD 20706-4833 | 2020-09-25 |
| 1588278469 | Js Medical | Durable Medical Equipment & Medical Supplies | 3304 Mount Airy Ct, Davidsonville, MD 21035-2209 | 2020-09-08 |
| 1083228373 | Js Products, LLC | Durable Medical Equipment & Medical Supplies | 11118 Reynolds Rd, Kingsville, MD 21087-1939 | 2020-09-03 |
| 1356953319 | Med-care Supplies, LLC | Durable Medical Equipment & Medical Supplies | 1406b Crain Hwy S Ste 205, Glen Burnie, MD 21061-4336 | 2020-08-20 |
| 1467063537 | Nai Saturn Eastern LLC | Durable Medical Equipment & Medical Supplies | 1800 Rockville Pike Ste S, Rockville, MD 20852-1604 | 2020-08-12 |
| Find all providers with the same taxonomy | ||||
| City | ELDERSBURG |
| Zip Code | 21784 |
Please comment or provide details below to improve the information on LIFEBRIDGE SPORTS MEDICINE AND REHABILITATION LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.