Healthcare Provider Details

I. General information

NPI: 1003786856
Provider Name (Legal Business Name): AMERICAN PRIMECARE & WELLNESS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2025
Last Update Date: 11/07/2025
Certification Date: 11/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

814 TOLL HOUSE AVE
FREDERICK MD
21701-4519
US

IV. Provider business mailing address

1009 BEXHILL DR
FREDERICK MD
21702-5192
US

V. Phone/Fax

Practice location:
  • Phone: 301-662-8310
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: RUBY JADE IBARRA
Title or Position: BUSINESS OWNER
Credential: CRNP
Phone: 443-842-1863