| Pricare Medical Center Llc | |
|
8113 Harford Rd Ste 100 Baltimore MD 21234-5790 | |
| (410) 882-4800 | |
| Not Available |
| Full Name | Pricare Medical Center Llc |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 8113 Harford Rd Ste 100, Baltimore, Maryland |
| Authorized Official Name and Position | Eveline Takang (OWNER) |
| Authorized Official Contact | 2402649698 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pricare Medical Center Llc 8113 Harford Rd Ste 100 Baltimore MD 21234-5790 Ph: () - | Pricare Medical Center Llc 8113 Harford Rd Ste 100 Baltimore MD 21234-5790 Ph: (410) 882-4800 |
| NPI Number | 1669983904 |
|---|---|
| Provider Enumeration Date | 10/13/2017 |
| Last Update Date | 10/13/2017 |
| Medicare PECOS PAC ID | 8224394911 |
|---|---|
| Medicare Enrollment ID | O20171114000029 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669983904 | NPI | - | NPPES |
| 983319600 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Secondary |
| 363LP2300X | Nurse Practitioner - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Eveline Takang |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548528599 PECOS PAC ID: 2466692207 Enrollment ID: I20171114000046 |
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