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ABSOLUTECARE OF BALTIMORE LLC NPI 1508295726


NPI Information

NPI: 1508295726
Provider Name: ABSOLUTECARE OF BALTIMORE, LLC
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

Address:
1040 PARK AVE
SUITE 200
BALTIMORE, MD
ZIP 21201
Phone: (443) 738-0300
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ABSOLUTECARE OF BALTIMORE, LLC is a primary care clinic center in Baltimore, MD. ABSOLUTECARE OF BALTIMORE, LLC NPI is 1508295726. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1040 PARK AVE
SUITE 200
BALTIMORE, MD
ZIP 21201
Phone: (443) 738-0300
Fax: (443) 738-0301

The provider's authorized official is Thomas J Trently .
The authorized official title is Cfo and has the following contact phone number (443) 738-0281.

The enumeration date for this NPI number is 11/7/2013 and was last updated on 2/3/2021.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily MedicineD0071154MARYLANDNo
2207R00000XInternal MedicineD53063MARYLANDNo
3363LA2200XNurse PractitionerAdult HealthR167803MARYLANDNo
4261QP2300XClinic/CenterPrimary CareYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
101938969OTHERMARYLANDAMERIGROUP MCO
2780015101MEDICAIDMARYLAND
3780015100MEDICAIDMARYLAND

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.