| Standard Healthcare Plus Llc | |
|
8102 Kittama Dr Clinton MD 20735-3155 | |
| (240) 643-1063 | |
| Not Available |
| Full Name | Standard Healthcare Plus Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 8102 Kittama Dr, Clinton, Maryland |
| Authorized Official Name and Position | Eric Yenchi (OWNER) |
| Authorized Official Contact | 2406431063 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Standard Healthcare Plus Llc 2403 Brooke Grove Rd Bowie MD 20721-1861 Ph: (240) 643-1063 | Standard Healthcare Plus Llc 8102 Kittama Dr Clinton MD 20735-3155 Ph: (240) 643-1063 |
| NPI Number | 1790357044 |
|---|---|
| Provider Enumeration Date | 07/15/2021 |
| Last Update Date | 07/29/2021 |
| Certification Date | 07/29/2021 |
| Medicare PECOS PAC ID | 7810391125 |
|---|---|
| Medicare Enrollment ID | O20210809003682 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790357044 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| Provider Name | Eric Yenchi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346723970 PECOS PAC ID: 4789008327 Enrollment ID: I20200716000122 |
| Provider Name | Collette Odibo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255661294 PECOS PAC ID: 6305256710 Enrollment ID: I20201112003040 |
| Provider Name | Berenice Mumbemsa Ngam |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245585611 PECOS PAC ID: 3476939398 Enrollment ID: I20220929003675 |
| Provider Name | Ruth Nchefor Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356696231 PECOS PAC ID: 8325431299 Enrollment ID: I20221018001892 |
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