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NPI Code Detail

MEDICARE: TRANSFORMATION CENTER WEIGHT LOSS

MEDICARE: TRANSFORMATION CENTER WEIGHT LOSS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QH0100XHealth Service Clinic/Center

General Provider Information

NPI Number : 1114540275
Entity Type Code : Organization
Provider Name (Legal Business Name) : TRANSFORMATION CENTER WEIGHT LOSS
Provider Business Mailing Address
First Line : 1020 EDGEWOOD RD
Second Line :
City : EDGEWOOD
State : MD
Zip : 21040-1606
Country : US
Telephone Number : 443-356-0007
Fax Number : 301-725-4394
Provider Business Practice Location Address
First Line : 1020 EDGEWOOD RD
Second Line :
City : EDGEWOOD
State : MD
Zip : 21040-1606
Country : US
Telephone Number : 443-356-0007
Fax Number : 301-725-4394
Authorized Official
Title or Position : OWNER
Name : EUGENIA CATERNOR
Credential : NP
Telephone Number : 443-356-0007
Provider Enumeration Date : 05/24/2020
Last Update Date : 05/24/2020

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Directions to “TRANSFORMATION CENTER WEIGHT LOSS ” Practice Location

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