Healthcare Provider Details

I. General information

NPI: 1831521913
Provider Name (Legal Business Name): MS-HC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2013
Last Update Date: 08/20/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1576 MERRITT BLVD SUITE 11B
DUNDALK MD
21222-2132
US

IV. Provider business mailing address

9601 PULASKI PARK DR SUITE 416
BALTIMORE MD
21220-1409
US

V. Phone/Fax

Practice location:
  • Phone: 410-282-8600
  • Fax: 410-282-0985
Mailing address:
  • Phone: 410-933-5678
  • Fax: 410-933-1823

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332900000X
TaxonomyNon-Pharmacy Dispensing Site
License Number
License Number State

VIII. Authorized Official

Name: LAWRENCE M YALICH
Title or Position: PRESIDENT
Credential: DC
Phone: 410-238-0140