| Pem Wellness Llc | |
|
21 W 25th St Baltimore MD 21218-5003 | |
| (443) 865-8695 | |
| Not Available |
| Full Name | Pem Wellness Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 21 W 25th St, Baltimore, Maryland |
| Authorized Official Name and Position | Ashley Lucas (OWNER) |
| Authorized Official Contact | 4438658695 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pem Wellness Llc 375 Chiseled Stone Rd Sykesville MD 21784-8656 Ph: (443) 865-8695 | Pem Wellness Llc 21 W 25th St Baltimore MD 21218-5003 Ph: (443) 865-8695 |
| NPI Number | 1376200345 |
|---|---|
| Provider Enumeration Date | 11/24/2021 |
| Last Update Date | 11/24/2021 |
| Medicare PECOS PAC ID | 4789078866 |
|---|---|
| Medicare Enrollment ID | O20220307001635 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376200345 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Ashley Lucas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558952689 PECOS PAC ID: 5698169779 Enrollment ID: I20220307001888 |
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