| Pikesville Health Services Llc | |
|
1209 Greenwood Rd Pikesville MD 21208-3609 | |
| (410) 484-8500 | |
| Not Available |
| Full Name | Pikesville Health Services Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1209 Greenwood Rd, Pikesville, Maryland |
| Authorized Official Name and Position | Amiel Chicheportiche (PROGRAM SPONSOR) |
| Authorized Official Contact | 4104848500 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pikesville Health Services Llc 2833 Smith Ave Ste 148 Baltimore MD 21209-1426 Ph: (410) 484-8500 | Pikesville Health Services Llc 1209 Greenwood Rd Pikesville MD 21208-3609 Ph: (410) 484-8500 |
| NPI Number | 1124658810 |
|---|---|
| Provider Enumeration Date | 01/22/2020 |
| Last Update Date | 01/22/2020 |
| Certification Date | 01/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124658810 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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