Home Primary Care, Llc | |
6940 Clearwind Court Baltimore MD 21209 | |
(410) 205-6525 | |
(410) 602-5303 |
Full Name | Home Primary Care, Llc |
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Speciality | Clinic/Center |
Location | 6940 Clearwind Court, Baltimore, Maryland |
Authorized Official Name and Position | Albert Fuzayl (MANAGING MEMBER) |
Authorized Official Contact | 4102056525 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Home Primary Care, Llc 6940 Clearwind Court Baltimore MD 21209 Ph: (410) 205-6525 | Home Primary Care, Llc 6940 Clearwind Court Baltimore MD 21209 Ph: (410) 205-6525 |
NPI Number | 1306186911 |
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Provider Enumeration Date | 02/19/2013 |
Last Update Date | 07/13/2022 |
Medicare PECOS PAC ID | 7517104367 |
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Medicare Enrollment ID | O20130515000049 |
Identifier | Type | State | Issuer |
---|---|---|---|
1306186911 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261Q00000X | Clinic/center | (* (Not Available)) | Primary |
Provider Name | Stephen L Kinney |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1972611051 PECOS PAC ID: 4880740562 Enrollment ID: I20090922000310 |
Provider Name | Katarzyna Fraczek |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1922451046 PECOS PAC ID: 7618259193 Enrollment ID: I20170117002363 |
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