Epec Clinic Llc | |
9110 Philadelphia Rd Ste 210 Baltimore MD 21237-4325 | |
(410) 419-9428 | |
Not Available |
Full Name | Epec Clinic Llc |
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Speciality | Family Medicine |
Location | 9110 Philadelphia Rd Ste 210, Baltimore, Maryland |
Authorized Official Name and Position | Lekeya Hutton (OWNER) |
Authorized Official Contact | 4435598354 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Epec Clinic Llc 9110 Philadelphia Rd Ste 210 Rosedale MD 21237-4325 Ph: (443) 559-8354 | Epec Clinic Llc 9110 Philadelphia Rd Ste 210 Baltimore MD 21237-4325 Ph: (410) 419-9428 |
NPI Number | 1316578917 |
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Provider Enumeration Date | 02/01/2020 |
Last Update Date | 01/12/2021 |
Medicare PECOS PAC ID | 9638507783 |
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Medicare Enrollment ID | O20200324000635 |
Identifier | Type | State | Issuer |
---|---|---|---|
1316578917 | NPI | - | NPPES |
152013000 | Medicaid | MD |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
261QR0405X | Clinic/center - Rehabilitation, Substance Use Disorder | (* (Not Available)) | Secondary |
Provider Name | Lekeya Hutton |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1467935957 PECOS PAC ID: 3072855402 Enrollment ID: I20190503000991 |
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