| Evercare Recovery | |
|
6 Rock Story Ct Randallstown MD 21133-2844 | |
| (443) 676-6123 | |
| Not Available |
| Full Name | Evercare Recovery |
|---|---|
| Speciality | Clinic/Center |
| Location | 6 Rock Story Ct, Randallstown, Maryland |
| Authorized Official Name and Position | Gideon T Fon (PRESIDENT) |
| Authorized Official Contact | 4436766123 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Evercare Recovery 6 Rock Story Ct Randallstown MD 21133-2844 Ph: (443) 676-6123 | Evercare Recovery 6 Rock Story Ct Randallstown MD 21133-2844 Ph: (443) 676-6123 |
| NPI Number | 1780390088 |
|---|---|
| Provider Enumeration Date | 01/30/2023 |
| Last Update Date | 01/30/2023 |
| Certification Date | 01/30/2023 |
| Medicare PECOS PAC ID | 0345606513 |
|---|---|
| Medicare Enrollment ID | O20230512000662 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780390088 | NPI | - | NPPES |
| Provider Name | Olayinka O Toby |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740825413 PECOS PAC ID: 7315371408 Enrollment ID: I20200707001934 |
| Provider Name | Gideon Tah Fon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891304887 PECOS PAC ID: 7810303674 Enrollment ID: I20210303001431 |
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