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General NPI Number Information
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NPI Number | 1659427144
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Entity Type | Organization
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Legal Business Name | KIMMAR MEDICAL ASSOCIATES
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Dates
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Enumeration Date | 01/26/2007
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Last Update Date | 05/28/2020
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Provider Practice Location Address
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Address Line | 7231 RITCHIE HWY SUITE B
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City | GLEN BURNIE
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State | MD
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Zip | 21061
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Country | US
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Telephone | 410-987-6430
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Fax | 410-987-6433
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Provider Business Mailing Address
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Address Line | 7231 RITCHIE HWY SUITE B
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City | GLEN BURNIE
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State | MD
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Zip | 21061
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Country | US
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Telephone | 410-987-6430
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Fax | 410-987-6433
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Authorized Official
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Title or Position | ADMINISTRATO
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Name | MISS KIM S SWAIN
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Credential | ADMINISTRATOR
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Telephone | 410-987-6430
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | R2340
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License Number State | MD
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