| Procare Wellness Llc | |
|
11155 Dolfield Blvd Ste 116 Owings Mills MD 21117-3289 | |
| (443) 868-4165 | |
| Not Available |
| Full Name | Procare Wellness Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 11155 Dolfield Blvd Ste 116, Owings Mills, Maryland |
| Authorized Official Name and Position | Iwalola Omojola (PRESIDENT) |
| Authorized Official Contact | 4438684165 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Procare Wellness Llc 11155 Dolfield Blvd Ste 116 Owings Mills MD 21117-3289 Ph: (443) 868-4165 | Procare Wellness Llc 11155 Dolfield Blvd Ste 116 Owings Mills MD 21117-3289 Ph: (443) 868-4165 |
| NPI Number | 1164259776 |
|---|---|
| Provider Enumeration Date | 09/17/2024 |
| Last Update Date | 09/17/2024 |
| Certification Date | 09/17/2024 |
| Medicare PECOS PAC ID | 9739610536 |
|---|---|
| Medicare Enrollment ID | O20241003003410 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164259776 | NPI | - | NPPES |
| Provider Name | Iwalola Stella Omojola |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477181857 PECOS PAC ID: 4981035854 Enrollment ID: I20200508000558 |
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