| Petro Health Llc | |
|
1403 Madison Park Dr Suite 200 Glen Burnie MD 21061-6189 | |
| (202) 317-1609 | |
| Not Available |
| Full Name | Petro Health Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1403 Madison Park Dr, Glen Burnie, Maryland |
| Authorized Official Name and Position | Armel Simo (PRESIDENT/PHYSICIAN) |
| Authorized Official Contact | 2023171609 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Petro Health Llc 4021 Zuni Ct Ellicott City MD 21043-5448 Ph: (410) 487-6902 | Petro Health Llc 1403 Madison Park Dr Suite 200 Glen Burnie MD 21061-6189 Ph: (202) 317-1609 |
| NPI Number | 1780087858 |
|---|---|
| Provider Enumeration Date | 10/03/2014 |
| Last Update Date | 10/20/2016 |
| Medicare PECOS PAC ID | 1456630615 |
|---|---|
| Medicare Enrollment ID | O20161111000980 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780087858 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | D75893 (Maryland) | Primary |
| Provider Name | Armel Simo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376708321 PECOS PAC ID: 9335319656 Enrollment ID: I20140325000124 |
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