| Cannakush Consulting Office Llc | |
|
5411 Old Frederick Rd Ste 18 Baltimore MD 21229-2126 | |
| (443) 750-0222 | |
| Not Available |
| Full Name | Cannakush Consulting Office Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 5411 Old Frederick Rd Ste 18, Baltimore, Maryland |
| Authorized Official Name and Position | Betsy Moore (OWNER) |
| Authorized Official Contact | 4437500222 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cannakush Consulting Office Llc 5411 Old Frederick Rd Ste 18 Baltimore MD 21229-2126 Ph: (443) 750-0222 | Cannakush Consulting Office Llc 5411 Old Frederick Rd Ste 18 Baltimore MD 21229-2126 Ph: (443) 750-0222 |
| NPI Number | 1215528369 |
|---|---|
| Provider Enumeration Date | 02/01/2021 |
| Last Update Date | 06/05/2024 |
| Certification Date | 06/05/2024 |
| Medicare PECOS PAC ID | 6305203308 |
|---|---|
| Medicare Enrollment ID | O20230607000476 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215528369 | NPI | - | NPPES |
| Provider Name | Betsy L White |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720565872 PECOS PAC ID: 1456784784 Enrollment ID: I20191127001147 |
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