| Comprehensive Healthcare & Wellness Services Llc | |
|
1014 Andean Goose Way Upper Marlboro MD 20774-7128 | |
| (240) 508-3363 | |
| Not Available |
| Full Name | Comprehensive Healthcare & Wellness Services Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1014 Andean Goose Way, Upper Marlboro, Maryland |
| Authorized Official Name and Position | Johanese Sandy (PROVIDER) |
| Authorized Official Contact | 2405083363 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Comprehensive Healthcare & Wellness Services Llc 1014 Andean Goose Way Upper Marlboro MD 20774-7128 Ph: (240) 508-3363 | Comprehensive Healthcare & Wellness Services Llc 1014 Andean Goose Way Upper Marlboro MD 20774-7128 Ph: (240) 508-3363 |
| NPI Number | 1366112385 |
|---|---|
| Provider Enumeration Date | 09/20/2021 |
| Last Update Date | 03/18/2022 |
| Medicare PECOS PAC ID | 2365837705 |
|---|---|
| Medicare Enrollment ID | O20220321002242 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366112385 | NPI | - | NPPES |
| 000000 | Medicaid | MD |
| Provider Name | Johanese Sandy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154819977 PECOS PAC ID: 1153674734 Enrollment ID: I20181029002026 |
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