| Bcb Liberty Health Care Llc | |
|
1638 R St Nw Washington DC 20009-6446 | |
| (937) 422-4093 | |
| Not Available |
| Full Name | Bcb Liberty Health Care Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1638 R St Nw, Washington, District Of Columbia |
| Authorized Official Name and Position | Caroline Bonu (PRESIDENT) |
| Authorized Official Contact | 3742240939 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bcb Liberty Health Care Llc 7410 Rigby Pl Elkridge MD 21075-7287 Ph: () - | Bcb Liberty Health Care Llc 1638 R St Nw Washington DC 20009-6446 Ph: (937) 422-4093 |
| NPI Number | 1518688100 |
|---|---|
| Provider Enumeration Date | 09/12/2022 |
| Last Update Date | 04/19/2023 |
| Certification Date | 04/19/2023 |
| Medicare PECOS PAC ID | 8426428301 |
|---|---|
| Medicare Enrollment ID | O20230518002983 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518688100 | NPI | - | NPPES |
| Provider Name | Caroline A Bonu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104592328 PECOS PAC ID: 4284030370 Enrollment ID: I20230518003083 |
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