Healthcare Provider Details

I. General information

NPI: 1427560887
Provider Name (Legal Business Name): B.WELL CONNECTED HEALTH, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2017
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

855 N WOLFE ST
BALTIMORE MD
21205-1503
US

IV. Provider business mailing address

5996 CALVERT WAY
ELDERSBURG MD
21784-8582
US

V. Phone/Fax

Practice location:
  • Phone: 443-570-5277
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code247000000X
TaxonomyHealth Information Technician
License Number
License Number State

VIII. Authorized Official

Name: YELENA BALIN
Title or Position: VP, OPERATIONS & TECHNOLOGY
Credential:
Phone: 443-570-5277