PRICARE MEDICAL CENTER LLC NPI 1669983904

NPI Information

NPI: 1669983904
Provider Name: PRICARE MEDICAL CENTER LLC
Classification: Nurse Practitioner - 363LP2300X
Entity Type: Organization

Specialization: Primary Care

CLIA Number: 21D2150713

Address:
8113 HARFORD RD STE 100
BALTIMORE, MD
ZIP 21234
Phone: (410) 882-4800
Get Directions

PRICARE MEDICAL CENTER LLC is a primary care nurse practitioner in Baltimore, MD. PRICARE MEDICAL CENTER LLC NPI is 1669983904. The provider is registered as an organization entity type.

The provider's business location address is:

8113 HARFORD RD STE 100
BALTIMORE, MD
ZIP 21234-790
Phone: (410) 882-4800

The provider's authorized official is Eveline Takang .
The authorized official title is Owner and has the following contact phone number (240) 264-9698.

The CLIA number assigned to this NPI record is 21D2150713 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/13/2017 and was last updated on 10/13/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QP2300X	Clinic/Center	Primary Care			No
2	363LP2300X	Nurse Practitioner	Primary Care			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	983319600	MEDICAID	MARYLAND

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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