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General NPI Number Information
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NPI Number | 1982226023
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Entity Type | Organization
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Legal Business Name | COMPLETE ACCESS CARE, LLC
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Dates
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Enumeration Date | 05/12/2020
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Last Update Date | 05/12/2020
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Provider Practice Location Address
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Address Line | 1035 INGLESIDE AVE
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City | CATONSVILLE
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State | MD
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Zip | 21228-1318
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Country | US
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Telephone | 410-663-4036
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Fax |
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Provider Business Mailing Address
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Address Line | 11532 GARRISON FOREST RD
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City | OWINGS MILLS
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State | MD
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Zip | 21117-2210
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ANDRE FOSTER
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Credential | NP
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Telephone | 410-663-4036
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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