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Organization
REDICARE MOBILE HEALTH SERVICE
Active
Organization
REDICARE MOBILE HEALTH SERVICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ASHLEY BROTHERS TOLLIVER PA-C (CEO/PHYSICIAN ASSISTANT)
(240) 743-8520
Entity
Organization
Contact information
Practice address
12410 MILESTONE CENTER DR STE 600, GERMANTOWN, MD 20876-7102
(240) 743-8520
Mailing address
12410 MILESTONE CENTER DR STE 600, GERMANTOWN, MD 20876-7102
(301) 307-5335
(667) 256-7022
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0010-10529
NC PHYSICIAN ASSISTANT LICENSE
NC
01
—
0110007406
VA PHYSICIAN ASSISTANT LICENSE
VA
01
—
C05839
MARYLAND PHYSICIAN ASSISTANT LICENSE
MD
01
—
PA031239
DISTRICT OF COLUMBIA PHYSICIAN ASSISTANT LICENSE
DC
01
—
PA86989
MD CDS
MD
Enumeration date
01/07/2020
Last updated
03/07/2023
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