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1361 Brass Mill Rd Suite A Bel Camp MD 21017 | |
(410) 273-9700 | |
(410) 273-9713 |
Full Name | |
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Speciality | Clinic/Center |
Location | 1361 Brass Mill Rd, Bel Camp, Maryland |
Authorized Official Name and Position | Bruce Jarvie (VP, TREASURER) |
Authorized Official Contact | 2143793300 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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1720 Lakepointe Dr Ste 117 Lewisville TX 75057-6425 Ph: (214) 379-3300 | 1361 Brass Mill Rd Suite A Bel Camp MD 21017 Ph: (410) 273-9700 |
NPI Number | 1689937260 |
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Provider Enumeration Date | 06/19/2012 |
Last Update Date | 07/29/2024 |
Certification Date | 07/29/2024 |
Medicare PECOS PAC ID | 7719314475 |
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Medicare Enrollment ID | O20200219002039 |
Identifier | Type | State | Issuer |
---|---|---|---|
1689937260 | NPI | - | NPPES |
0019661780001 | Medicaid | PA | |
905637 | Other | MD | LICENSE |
403453800 | Medicaid | MD | |
39191306 | Medicaid | MD |