Healthcare Provider Details
I. General information
NPI: 1871266437
Provider Name (Legal Business Name): KROWNE HEALTH CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/29/2021
Last Update Date: 04/02/2024
Certification Date: 04/02/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5513 TWIN KNOLLS RD STE 213
COLUMBIA MD
21045-3264
US
IV. Provider business mailing address
5513 TWIN KNOLLS RD STE 213
COLUMBIA MD
21045-3264
US
V. Phone/Fax
- Phone: 240-647-5687
- Fax:
- Phone: 240-647-5687
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ADISATU
ADEYEMI
Title or Position: OWNER
Credential:
Phone: 240-771-0885