Healthcare Provider Details

I. General information

NPI: 1407735079
Provider Name (Legal Business Name): AMANE HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2025
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16701 MELFORD BLVD STE 400
BOWIE MD
20715-4411
US

IV. Provider business mailing address

16701 MELFORD BLVD STE 400
BOWIE MD
20715-4411
US

V. Phone/Fax

Practice location:
  • Phone: 301-321-8885
  • Fax:
Mailing address:
  • Phone: 301-321-8885
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QF0050X
TaxonomyNon-Surgical Family Planning Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. TIFFANY GARRETT
Title or Position: CEO
Credential: DO
Phone: 301-321-8885