MEDICARE: ZETTA HEALTHCARE LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	103K00000X	Behavior Analyst
2	251F00000X	Home Infusion Agency
3	251S00000X	Community/Behavioral Health Agency
4	332B00000X	Durable Medical Equipment & Medical Supplies
5	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1598248304
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ZETTA HEALTHCARE LLC

Provider Business Mailing Address
First Line	:	145 W OSTEND ST STE 600
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21230-3774
Country	:	US
Telephone Number	:	240-542-8509
Fax Number	:

Provider Business Practice Location Address
First Line	:	145 W OSTEND ST STE 600
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21230-3774
Country	:	US
Telephone Number	:	240-542-8509
Fax Number	:

Authorized Official
Title or Position	:	MANAGING PARTNER/CEO
Name	:	ARVEL JOHNSON
Credential	:
Telephone Number	:	240-542-8509

Provider Enumeration Date	:	09/09/2018
Last Update Date	:	05/09/2019

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Directions to “ZETTA HEALTHCARE LLC ” Practice Location

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