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Organization

PRICARE MEDICAL CENTER LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
EVELINE TAKANG CRNP (OWNER)
(240) 264-9698
Entity
Organization

Contact information

Practice address
8113 HARFORD RD STE 100, BALTIMORE, MD 21234-5790
(410) 882-4800
Mailing address
8113 HARFORD RD STE 100, BALTIMORE, MD 21234-5790

Taxonomy

Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
363LP2300X
Primary Care Nurse Practitioner
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
983319600
MD
Enumeration date
10/13/2017
Last updated
10/13/2017
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