Healthcare Provider Details

I. General information

NPI: 1700971280
Provider Name (Legal Business Name): I CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 07/27/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 HOSPITAL DRIVE
PRINCE FREDERICK MD
20678
US

IV. Provider business mailing address

8909 OLD BRANCH AVE
CLINTON MD
20735
US

V. Phone/Fax

Practice location:
  • Phone: 301-868-7274
  • Fax: 301-861-4367
Mailing address:
  • Phone: 301-868-7274
  • Fax: 301-861-4671

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: MARYANN MILLER
Title or Position: PRAC ADMIN
Credential:
Phone: 301-868-7274