MEDICARE: WHOLISTIC FAMILY HEALTHCARE, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171100000X	Acupuncturist	U01179	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	BG43	OTHER	MD	CAREFIRST BC/BS

General Provider Information

NPI Number	:	1457757114
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WHOLISTIC FAMILY HEALTHCARE, INC.

Provider Business Mailing Address
First Line	:	10863 LOCKWOOD DR
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20901-1552
Country	:	US
Telephone Number	:	301-495-0303
Fax Number	:

Provider Business Practice Location Address
First Line	:	8830 CAMERON ST STE 602
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20910-4158
Country	:	US
Telephone Number	:	301-495-0303
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. SIMEON POLLOCK
Credential	:	L.AC., L.M.T.
Telephone Number	:	301-495-0303

Provider Enumeration Date	:	11/07/2014
Last Update Date	:	11/07/2014

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