Healthcare Provider Details

I. General information

NPI: 1992496145
Provider Name (Legal Business Name): STICK WITH ME INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2023
Last Update Date: 05/18/2023
Certification Date: 05/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7704 MARWOOD DR
CLINTON MD
20735-1473
US

IV. Provider business mailing address

7704 MARWOOD DR
CLINTON MD
20735-1473
US

V. Phone/Fax

Practice location:
  • Phone: 301-503-6703
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QE0002X
TaxonomyEmergency Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ASHLEY PHILLIPS
Title or Position: PHLEBOTOMIST
Credential:
Phone: 301-503-6703