Redeem Healthcare And Medical Systems 11 Inc | |
2127 W Pratt St Baltimore MD 21223-2244 | |
(410) 878-0655 | |
Not Available |
Full Name | Redeem Healthcare And Medical Systems 11 Inc |
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Speciality | Clinic/Center |
Location | 2127 W Pratt St, Baltimore, Maryland |
Authorized Official Name and Position | Ose Okojie (OWNER) |
Authorized Official Contact | 4436292435 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Redeem Healthcare And Medical Systems 11 Inc 2127 W Pratt St Baltimore MD 21223-2244 Ph: (410) 878-0655 | Redeem Healthcare And Medical Systems 11 Inc 2127 W Pratt St Baltimore MD 21223-2244 Ph: (410) 878-0655 |
NPI Number | 1083351134 |
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Provider Enumeration Date | 05/18/2022 |
Last Update Date | 10/03/2022 |
Certification Date | 10/03/2022 |
Medicare PECOS PAC ID | 5294113049 |
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Medicare Enrollment ID | O20221019003348 |
Identifier | Type | State | Issuer |
---|---|---|---|
1083351134 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
Provider Name | Edward C Whitfield |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1740690973 PECOS PAC ID: 4789803487 Enrollment ID: I20140911000615 |
Provider Name | Victoria O Ajayi |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1194221788 PECOS PAC ID: 6204188519 Enrollment ID: I20181016000776 |
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