Organization
TOTAL IMAGE CARE, INC.
Active
Parent organization
TOTAL IMAGE CARE, INC
Other names
Image Recovery Center at Upper Chesapeake
Organization subpart
Yes
Provider details
NPI number
Legal business name
TOTAL IMAGE CARE, INC
Authorized official
MR. EDWARD JEROME KELLY III MBA, CPA (CEO)
(410) 560-0614
Entity
Organization
Contact information
Practice address
500 UPPER CHESAPEAKE DR, SUITE 11, BEL AIR, MD 21014-4324
(443) 643-3224
(443) 643-3227
Mailing address
1850 YORK RD, SUITE I, LUTHERVILLE, MD 21093-5122
(410) 560-0614
(410) 560-0613
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6010000800
—
MD
01
—
F807
CAREFIRST BLUE CROSS BLUE SHIELD
MD
01
—
MH24
CAREFIRST BLUE CROSS BLUE SHIELD
MD
Enumeration date
10/03/2013
Last updated
10/03/2013
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