Organization
ZIPPORAH ELAN
Active
Other names
Home Prostheticare
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TERRY MICHAEL ELAN CP (VICE PRESIDENT PROSTHETIST)
(410) 486-4796
Entity
Organization
Contact information
Practice address
301 REISTERSTOWN RD, FL 1, BALTIMORE, MD 21208-5313
(410) 486-4796
(410) 486-9749
Mailing address
301 REISTERSTOWN RD, FL 1, BALTIMORE, MD 21208-5313
(410) 486-4796
(410) 486-9749
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
CP2000
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1028269
ACM
—
05
—
501038100
—
MD
01
—
58080901
BCBS
—
01
—
59336
AMERIGROUP
—
01
—
63340001
BCBS
—
01
—
Y120
BCBS
—
Enumeration date
06/04/2007
Last updated
06/17/2008
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