Healthcare Provider Details

I. General information

NPI: 1982844676
Provider Name (Legal Business Name): LIFE CARE PLUS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2009
Last Update Date: 02/20/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5051 GREENSPRING AVE SUITE 100
BALTIMORE MD
21209-4355
US

IV. Provider business mailing address

5051 GREENSPRING AVE SUITE 100
BALTIMORE MD
21209-4355
US

V. Phone/Fax

Practice location:
  • Phone: 410-664-8304
  • Fax: 410-542-7468
Mailing address:
  • Phone: 410-664-8304
  • Fax: 410-542-7468

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number StateMD

VIII. Authorized Official

Name: DR. MICHAEL LAWRENCE ZOLLICOFFER
Title or Position: OWNER
Credential: M.D.
Phone: 410-664-8304