Healthcare Provider Details

I. General information

NPI: 1306160015
Provider Name (Legal Business Name): BWELL HEALTHCARE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2010
Last Update Date: 03/24/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

270 BROCK BRIDGE RD
LAUREL MD
20724-2216
US

IV. Provider business mailing address

270 BROCK BRIDGE RD
LAUREL MD
20724-2216
US

V. Phone/Fax

Practice location:
  • Phone: 301-710-5340
  • Fax: 301-358-2832
Mailing address:
  • Phone: 301-710-5340
  • Fax: 301-358-2832

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License NumberR2862
License Number StateMD

VIII. Authorized Official

Name: FEMMY KUTI
Title or Position: OPERATIONS MANAGER
Credential:
Phone: 301-710-5340