| Compassionate Wellness Center, Llc | |
|
44 N Potomac St Ste 101&102 Hagerstown MD 21740 | |
| (240) 513-6001 | |
| (240) 513-6122 |
| Full Name | Compassionate Wellness Center, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 44 N Potomac St Ste 101&102, Hagerstown, Maryland |
| Authorized Official Name and Position | Ivan N. Zama (PRESIDENT) |
| Authorized Official Contact | 2405136001 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Compassionate Wellness Center, Llc 10319 Westlake Dr Ste 335 Bethesda MD 20817-6403 Ph: () - | Compassionate Wellness Center, Llc 44 N Potomac St Ste 101&102 Hagerstown MD 21740 Ph: (240) 513-6001 |
| NPI Number | 1811408057 |
|---|---|
| Provider Enumeration Date | 10/16/2017 |
| Last Update Date | 10/01/2024 |
| Medicare PECOS PAC ID | 5395003305 |
|---|---|
| Medicare Enrollment ID | O20171221000625 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811408057 | NPI | - | NPPES |
| 986006100 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| 207RH0002X | Internal Medicine - Hospice And Palliative Medicine | (* (Not Available)) | Primary |
| Provider Name | Folake D Aloba |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255753489 PECOS PAC ID: 9436382249 Enrollment ID: I20140501001798 |
| Provider Name | William Haynes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831610161 PECOS PAC ID: 5092086611 Enrollment ID: I20170801000125 |
| Provider Name | Michelle Ramirez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1992101463 PECOS PAC ID: 7618233768 Enrollment ID: I20171107001023 |
| Provider Name | Ivan Zama |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912177288 PECOS PAC ID: 5395874788 Enrollment ID: I20180131001300 |
| Provider Name | Stacy Bratburd |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699144055 PECOS PAC ID: 6305193186 Enrollment ID: I20180725001212 |
| Provider Name | Marinette N Zibi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548610215 PECOS PAC ID: 9931534393 Enrollment ID: I20200114001266 |
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