| Vital Sources, Llc | |
|
116 Record St Frederick MD 21701-5418 | |
| (301) 620-8700 | |
| (301) 620-8710 |
| Full Name | Vital Sources, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 116 Record St, Frederick, Maryland |
| Authorized Official Name and Position | James E. Roembke (MEMBER) |
| Authorized Official Contact | 3016208700 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vital Sources, Llc 116 Record St Frederick MD 21701-5418 Ph: (301) 620-8700 | Vital Sources, Llc 116 Record St Frederick MD 21701-5418 Ph: (301) 620-8700 |
| NPI Number | 1770605321 |
|---|---|
| Provider Enumeration Date | 04/04/2007 |
| Last Update Date | 07/05/2016 |
| Medicare PECOS PAC ID | 6901864156 |
|---|---|
| Medicare Enrollment ID | O20041221000056 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770605321 | NPI | - | NPPES |
| Provider Name | James E Roembke |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1285756767 PECOS PAC ID: 3173581329 Enrollment ID: I20041222000028 |
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