Healthcare Provider Details

I. General information

NPI: 1538866116
Provider Name (Legal Business Name): LUMINIS HEALTH GILCHRIST LIFECARE INSTITUTE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2023
Last Update Date: 06/05/2023
Certification Date: 06/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 MEDICAL PKWY STE 607
ANNAPOLIS MD
21401-3748
US

IV. Provider business mailing address

6701 N CHARLES ST BLDG STE 102
BALTIMORE MD
21204-6808
US

V. Phone/Fax

Practice location:
  • Phone: 443-332-5800
  • Fax:
Mailing address:
  • Phone: 443-849-2459
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: ELIZABETH LEE
Title or Position: CFO
Credential:
Phone: 410-542-7800