Prime Care House Calls Pc | |
2760 Wynfield Rd West Friendship MD 21794-9519 | |
(443) 280-3480 | |
Not Available |
Full Name | Prime Care House Calls Pc |
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Speciality | Clinic/Center |
Location | 2760 Wynfield Rd, West Friendship, Maryland |
Authorized Official Name and Position | Sandra Mary Nettina (PRESIDENT) |
Authorized Official Contact | 4432803480 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Prime Care House Calls Pc 2760 Wynfield Rd West Friendship MD 21794-9519 Ph: (443) 280-3480 | Prime Care House Calls Pc 2760 Wynfield Rd West Friendship MD 21794-9519 Ph: (443) 280-3480 |
NPI Number | 1548658438 |
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Provider Enumeration Date | 12/31/2014 |
Last Update Date | 12/31/2014 |
Medicare PECOS PAC ID | 9537483581 |
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Medicare Enrollment ID | O20150121001889 |
Identifier | Type | State | Issuer |
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1548658438 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QP2300X | Clinic/center - Primary Care | R109061 (Maryland) | Primary |
Provider Name | Sandra M Nettina |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1407880131 PECOS PAC ID: 7113983073 Enrollment ID: I20041202000999 |
Provider Name | Marinet Ade Kamga |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1356967855 PECOS PAC ID: 4486061819 Enrollment ID: I20210331000146 |