Healthcare Provider Details

I. General information

NPI: 1699576462
Provider Name (Legal Business Name): CARECO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/19/2025
Last Update Date: 03/19/2025
Certification Date: 03/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 S CLINTON ST
BALTIMORE MD
21224-5730
US

IV. Provider business mailing address

1501 S CLINTON ST
BALTIMORE MD
21224-5730
US

V. Phone/Fax

Practice location:
  • Phone: 410-998-7873
  • Fax:
Mailing address:
  • Phone: 410-998-7873
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WD0400X
TaxonomyDiabetes Educator Registered Nurse
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: TROY R SMITH
Title or Position: VP COST OF CARE, CARE PARTNERSHIP
Credential:
Phone: 919-259-0524