Healthcare Provider Details

I. General information

NPI: 1598023194
Provider Name (Legal Business Name): HEALTH FIRST MEDICAL CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/02/2012
Last Update Date: 02/06/2020
Certification Date: 02/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9650 SANTIAGO RD STE 6
COLUMBIA MD
21045-3960
US

IV. Provider business mailing address

PO BOX 6303
ELLICOTT CITY MD
21042-0303
US

V. Phone/Fax

Practice location:
  • Phone: 410-992-7005
  • Fax:
Mailing address:
  • Phone: 866-241-1629
  • Fax: 866-343-0694

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. MAGGIE FUNK
Title or Position: MANAGER
Credential:
Phone: 410-469-7905