| Win Team, Llc | |
|
4640 Edmondson Ave Baltimore MD 21229-1407 | |
| (443) 919-9999 | |
| Not Available |
| Full Name | Win Team, Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 4640 Edmondson Ave, Baltimore, Maryland |
| Authorized Official Name and Position | Al W Laws (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 4438588240 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Win Team, Llc 2502 W Northern Pkwy Baltimore MD 21215-4707 Ph: (410) 578-8003 | Win Team, Llc 4640 Edmondson Ave Baltimore MD 21229-1407 Ph: (443) 919-9999 |
| NPI Number | 1942519202 |
|---|---|
| Provider Enumeration Date | 10/04/2010 |
| Last Update Date | 07/11/2022 |
| Certification Date | 07/11/2022 |
| Medicare PECOS PAC ID | 2961737077 |
|---|---|
| Medicare Enrollment ID | O20190711002565 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942519202 | NPI | - | NPPES |
| Provider Name | Yolanda Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992279665 PECOS PAC ID: 4284964230 Enrollment ID: I20190918001382 |
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