Healthcare Provider Details

I. General information

NPI: 1386275857
Provider Name (Legal Business Name): CMAG HEALTH SOLUTIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/03/2020
Last Update Date: 04/28/2020
Certification Date: 04/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11155 DOLFIELD BLVD STE 110
OWINGS MILLS MD
21117-3289
US

IV. Provider business mailing address

11155 DOLFIELD BLVD STE 110
OWINGS MILLS MD
21117-3289
US

V. Phone/Fax

Practice location:
  • Phone: 410-517-2624
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: ANGELA GUSTUS
Title or Position: CEO/ CO- OWNER
Credential:
Phone: 410-517-2624