| Vitality 360 Health Care Llc | |
|
6018 Harford Rd Baltimore MD 21214-1327 | |
| (301) 996-4885 | |
| Not Available |
| Full Name | Vitality 360 Health Care Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 6018 Harford Rd, Baltimore, Maryland |
| Authorized Official Name and Position | Bilikisu Osman (PRESIDENT) |
| Authorized Official Contact | 3019964885 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vitality 360 Health Care Llc 6018 Harford Rd Baltimore MD 21214-1327 Ph: (301) 996-4885 | Vitality 360 Health Care Llc 6018 Harford Rd Baltimore MD 21214-1327 Ph: (301) 996-4885 |
| NPI Number | 1013692599 |
|---|---|
| Provider Enumeration Date | 06/21/2023 |
| Last Update Date | 06/21/2023 |
| Medicare PECOS PAC ID | 7517329121 |
|---|---|
| Medicare Enrollment ID | O20230815000243 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013692599 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Bilikisu Osman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689213050 PECOS PAC ID: 5890124879 Enrollment ID: I20200327000209 |
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