Organization
ABODE CARE PARTNERS AL VB, LLC
Active
Parent organization
SHC MEDICAL PARTNERS, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
SHC MEDICAL PARTNERS, LLC
Authorized official
ANGIE MATTINGLY (MGR PROVIDER ENROLLMENT)
(502) 394-2100
Entity
Organization
Contact information
Practice address
21412 GREAT MILLS RD, LEXINGTON PK, MD 20653-1203
(301) 863-7244
(301) 863-8550
Mailing address
12201 BLUEGRASS PKWY, LOUISVILLE, KY 40299-2361
(502) 568-7896
(502) 568-7136
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
—
Other
Enumeration date
04/06/2010
Last updated
12/26/2023
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