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General NPI Number Information
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NPI Number | 1467092866
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Entity Type | Organization
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Legal Business Name | FOREMAN'S IMPERIAL HEALTH, LLC
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Dates
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Enumeration Date | 01/14/2020
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Last Update Date | 01/14/2020
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Provider Practice Location Address
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Address Line | 11710 REISTERSTOWN RD STE 207
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City | REISTERSTOWN
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State | MD
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Zip | 21136-3363
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Country | US
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Telephone | 301-326-9090
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Fax |
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Provider Business Mailing Address
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Address Line | 3910 SUSANNA RD
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City | RANDALLSTOWN
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State | MD
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Zip | 21133-4056
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Country | US
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Telephone | 301-326-9090
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Fax |
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Authorized Official
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Title or Position | OWNER OF ENTITY
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Name | CHRISTINA D FOREMAN
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Credential | FNP
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Telephone | 301-326-9090
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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