| True Vine Health Systems Inc. | |
|
6239 Seton Hills Ln Gwynn Oak MD 21207-6098 | |
| (443) 469-9528 | |
| Not Available |
| Full Name | True Vine Health Systems Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 6239 Seton Hills Ln, Gwynn Oak, Maryland |
| Authorized Official Name and Position | Bola Osunkiyesi (PRESIDENT) |
| Authorized Official Contact | 4434699528 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| True Vine Health Systems Inc. 6239 Seton Hills Ln Gwynn Oak MD 21207-6098 Ph: (443) 469-9528 | True Vine Health Systems Inc. 6239 Seton Hills Ln Gwynn Oak MD 21207-6098 Ph: (443) 469-9528 |
| NPI Number | 1831830231 |
|---|---|
| Provider Enumeration Date | 04/07/2022 |
| Last Update Date | 04/08/2022 |
| Certification Date | 04/08/2022 |
| Medicare PECOS PAC ID | 8921489048 |
|---|---|
| Medicare Enrollment ID | O20220721000839 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831830231 | NPI | - | NPPES |
| Provider Name | Bola Osunkiyesi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427651561 PECOS PAC ID: 4880001585 Enrollment ID: I20220217000303 |
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