MEDICARE: MS-HC, LLC

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
1	332900000X	Non-Pharmacy Dispensing Site

General Provider Information

NPI Number	:	1841630043
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MS-HC, LLC

Provider Business Mailing Address
First Line	:	9601 PULASKI PARK DR
Second Line	:	SUITE 416
City	:	BALTIMORE
State	:	MD
Zip	:	21220-1409
Country	:	US
Telephone Number	:	410-933-5678
Fax Number	:	410-933-1823

Provider Business Practice Location Address
First Line	:	7503B ANNAPOLIS RD
Second Line	:
City	:	HYATTSVILLE
State	:	MD
Zip	:	20784-1701
Country	:	US
Telephone Number	:	240-296-1112
Fax Number	:	240-296-1097

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. LAWRENCE M YALICH
Credential	:	DC
Telephone Number	:	410-238-0140

Provider Enumeration Date	:	07/02/2013
Last Update Date	:	08/20/2014

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