Organization
TOTAL IMAGE CARE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EDWARD JEROME KELLY III (CEO)
(410) 560-0614
Entity
Organization
Contact information
Practice address
601 N BROADWAY ST, SUITE 1300, BALTIMORE, MD 21287-0001
(410) 502-5623
(410) 502-5622
Mailing address
800 ARMY RD, TOWSON, MD 21204-6701
(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
—
6010008
—
MD
01
—
F807
CAREFIRST BCBS
DC
01
—
MH24
CAREFIRST BCBS
MD
Enumeration date
12/31/2008
Last updated
10/07/2010
Update your record
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