Jolye Llc | |
3004 Ailsa Ave Ste E Baltimore MD 21214-2968 | |
(410) 941-8212 | |
(410) 941-8244 |
Full Name | Jolye Llc |
---|---|
Speciality | Clinic/Center |
Location | 3004 Ailsa Ave Ste E, Baltimore, Maryland |
Authorized Official Name and Position | Abiola Oshin (PRESIDENT) |
Authorized Official Contact | 4109418212 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Jolye Llc 31 Greenleaf Rd Parkville MD 21234-3369 Ph: (109) 418-2124 | Jolye Llc 3004 Ailsa Ave Ste E Baltimore MD 21214-2968 Ph: (410) 941-8212 |
NPI Number | 1144810177 |
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Provider Enumeration Date | 01/23/2021 |
Last Update Date | 08/23/2023 |
Medicare PECOS PAC ID | 0446614523 |
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Medicare Enrollment ID | O20230907001828 |
Identifier | Type | State | Issuer |
---|---|---|---|
1144810177 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
363LP2300X | Nurse Practitioner - Primary Care | (* (Not Available)) | Secondary |
Provider Name | Abiola E Oshin |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1396376075 PECOS PAC ID: 5597166546 Enrollment ID: I20210628002870 |
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