| Black Rock Integrative Medicine | |
|
120 N Potomac St Hagerstown MD 21740-4810 | |
| (301) 790-4938 | |
| (301) 850-2135 |
| Full Name | Black Rock Integrative Medicine |
|---|---|
| Speciality | Clinic/Center |
| Location | 120 N Potomac St, Hagerstown, Maryland |
| Authorized Official Name and Position | Sheri Denham (NURSE PRACTITIONER/ OWNER) |
| Authorized Official Contact | 3017904938 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Black Rock Integrative Medicine 20615 Woodbridge Dr Hagerstown MD 21742-3188 Ph: (301) 790-4938 | Black Rock Integrative Medicine 120 N Potomac St Hagerstown MD 21740-4810 Ph: (301) 790-4938 |
| NPI Number | 1285102764 |
|---|---|
| Provider Enumeration Date | 11/02/2018 |
| Last Update Date | 07/08/2024 |
| Medicare PECOS PAC ID | 1052793312 |
|---|---|
| Medicare Enrollment ID | O20220803000141 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285102764 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Sheri Denham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295279214 PECOS PAC ID: 7618251315 Enrollment ID: I20170224000093 |
| Provider Name | Carmen A Howe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689328395 PECOS PAC ID: 0648665661 Enrollment ID: I20220309002053 |
| Provider Name | Kelly Ann Nye Small |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063198810 PECOS PAC ID: 1153777297 Enrollment ID: I20231026001487 |
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