| Healthy Generations Comprehensive Care Llc | |
|
7850 Rossville Blvd Ste 210 Nottingham MD 21236-3934 | |
| (443) 961-6164 | |
| Not Available |
| Full Name | Healthy Generations Comprehensive Care Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 7850 Rossville Blvd Ste 210, Nottingham, Maryland |
| Authorized Official Name and Position | Shavon Trenice Darden (PROVIDER) |
| Authorized Official Contact | 4439616164 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Healthy Generations Comprehensive Care Llc 722 Dulaney Valley Rd Ste 259 Towson MD 21204-5109 Ph: (443) 961-6164 | Healthy Generations Comprehensive Care Llc 7850 Rossville Blvd Ste 210 Nottingham MD 21236-3934 Ph: (443) 961-6164 |
| NPI Number | 1417563883 |
|---|---|
| Provider Enumeration Date | 09/21/2020 |
| Last Update Date | 10/05/2020 |
| Medicare PECOS PAC ID | 8628489630 |
|---|---|
| Medicare Enrollment ID | O20201124000649 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417563883 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Shavon T Darden |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972502680 PECOS PAC ID: 2961445366 Enrollment ID: I20050607000514 |
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