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General NPI Number Information
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NPI Number | 1467978866
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Entity Type | Organization
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Legal Business Name | MEDICAL CARE AT HOME, LLC
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Dates
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Enumeration Date | 08/17/2017
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Last Update Date | 11/09/2017
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Provider Practice Location Address
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Address Line | 2005 JOLLY RD
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City | BALTIMORE
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State | MD
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Zip | 21209-1013
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Country | US
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Telephone | 410-941-9040
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Fax |
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Provider Business Mailing Address
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Address Line | 2005 JOLLY RD
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City | BALTIMORE
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State | MD
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Zip | 21209-1013
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Country | US
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Telephone | 14109419040
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | MRS. SLAVA KREYNOVICH
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Credential | CRNP
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Telephone | 410-941-9040
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State | MD
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