Park West Health Systems Incorporated | |
3319 W Belvedere Ave Baltimore MD 21215-5103 | |
(410) 542-7800 | |
Not Available |
Full Name | Park West Health Systems Incorporated |
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Speciality | Clinic/Center |
Location | 3319 W Belvedere Ave, Baltimore, Maryland |
Authorized Official Name and Position | Terri Mitchell (CEO) |
Authorized Official Contact | 4105427800 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Park West Health Systems Incorporated 3319 W Belvedere Ave Baltimore MD 21215-5103 Ph: (410) 542-7800 | Park West Health Systems Incorporated 3319 W Belvedere Ave Baltimore MD 21215-5103 Ph: (410) 542-7800 |
NPI Number | 1205896719 |
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Provider Enumeration Date | 03/27/2006 |
Last Update Date | 05/20/2011 |
Medicare PECOS PAC ID | 8921090820 |
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Medicare Enrollment ID | O20110524000216 |
Identifier | Type | State | Issuer |
---|---|---|---|
1205896719 | NPI | - | NPPES |
912391100 | Medicaid | MD |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Maryland) | Primary |
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