Park West Health Systems, Incorporated | |
5101 Lanier Ave Baltimore MD 21215-5321 | |
(410) 542-7800 | |
(410) 542-5279 |
Full Name | Park West Health Systems, Incorporated |
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Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | 5101 Lanier Ave, Baltimore, Maryland |
Authorized Official Name and Position | Terri Mitchell (CREDENTIALING) |
Authorized Official Contact | 4105427800 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
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 5101 Lanier Ave Baltimore MD 21215-5321 Ph: (410) 542-7800 |
NPI Number | 1518013283 |
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Provider Enumeration Date | 01/26/2007 |
Last Update Date | 05/25/2011 |
Identifier | Type | State | Issuer |
---|---|---|---|
1518013283 | NPI | - | NPPES |
912391100 | Medicaid | MD |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Maryland) | Primary |
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