Healthcare Provider Details
I. General information
NPI: 1659598167
Provider Name (Legal Business Name): HUMANIM TRIAGE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/19/2007
Last Update Date: 07/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6355 WOODSIDE CT
COLUMBIA MD
21046-1071
US
IV. Provider business mailing address
6355 WOODSIDE CT
COLUMBIA MD
21046-1071
US
V. Phone/Fax
- Phone: 410-381-7171
- Fax: 410-381-5137
- Phone: 410-381-7171
- Fax: 410-381-5137
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
GALE
BRITTON
Title or Position: DIR OF BILLING
Credential:
Phone: 410-381-7171