| |
4615 Park Heights Ave Baltimore MD 21215-6331 | |
(443) 423-1500 | |
(443) 423-1495 |
Full Name | |
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Speciality | Clinic/center |
Location | 4615 Park Heights Ave, Baltimore, Maryland |
Authorized Official Name and Position | Mike Williams (SR. CONTRACTING MANAGER) |
Authorized Official Contact | 4843383731 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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106 W Main St Norristown PA 19401-4716 Ph: (610) 239-9600 | 4615 Park Heights Ave Baltimore MD 21215-6331 Ph: (443) 423-1500 |
NPI Number | 1366656175 |
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Provider Enumeration Date | 05/10/2007 |
Last Update Date | 06/24/2021 |
Identifier | Type | State | Issuer |
---|---|---|---|
1366656175 | NPI | - | NPPES |
4171233 00 | Medicaid | MD |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | 10478 (Maryland) | Primary |
261QR0405X | Clinic/center - Rehabilitation, Substance Use Disorder | 12536 (Maryland) | Secondary |
Plume Health Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 200 E Pratt St, Baltimore, MD 21202 Phone: 720-248-4483 | |
Np Medical Solutions By Sheila Waller Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 5119 Mcfaul Rd, Baltimore, MD 21206 Phone: 443-531-6248 | |
Health Care For The Homeless, Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 421 Fallsway, Baltimore, MD 21202 Phone: 410-837-5533 Fax: 410-837-8020 |