| Act Health Integrated Services, Llc | |
|
800 S Frederick Ave Ste 208 Gaithersburg MD 20877-4152 | |
| (301) 679-5770 | |
| (301) 235-1520 |
| Full Name | Act Health Integrated Services, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 800 S Frederick Ave Ste 208, Gaithersburg, Maryland |
| Authorized Official Name and Position | Mary Fowaah Boateng (FAMILY NURSE PRACTITIONER) |
| Authorized Official Contact | 3016795770 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Act Health Integrated Services, Llc 800 S Frederick Ave Ste 208 Gaithersburg MD 20877-4152 Ph: (301) 679-5770 | Act Health Integrated Services, Llc 800 S Frederick Ave Ste 208 Gaithersburg MD 20877-4152 Ph: (301) 679-5770 |
| NPI Number | 1871088641 |
|---|---|
| Provider Enumeration Date | 06/25/2018 |
| Last Update Date | 09/12/2023 |
| Medicare PECOS PAC ID | 9638429962 |
|---|---|
| Medicare Enrollment ID | O20180907002183 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871088641 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | R214992 (Maryland) | Primary |
| Provider Name | Mary Fowaah Boateng |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205343498 PECOS PAC ID: 0547510877 Enrollment ID: I20180907002230 |
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