| Electrolife Infusion Llc | |
|
4500 Forbes Blvd Ste 200-w21 Lanham MD 20706-6312 | |
| (240) 244-7222 | |
| Not Available |
| Full Name | Electrolife Infusion Llc |
|---|---|
| Speciality | Registered Nurse |
| Location | 4500 Forbes Blvd Ste 200-w21, Lanham, Maryland |
| Authorized Official Name and Position | Tatyana Alethia Worthy (DIRECTOR) |
| Authorized Official Contact | 2402447222 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Electrolife Infusion Llc 4500 Forbes Blvd Ste 200-w21 Lanham MD 20706-6312 Ph: (240) 244-7222 | Electrolife Infusion Llc 4500 Forbes Blvd Ste 200-w21 Lanham MD 20706-6312 Ph: (240) 244-7222 |
| NPI Number | 1831789502 |
|---|---|
| Provider Enumeration Date | 01/26/2021 |
| Last Update Date | 10/08/2024 |
| Certification Date | 10/08/2024 |
| Medicare PECOS PAC ID | 7517491715 |
|---|---|
| Medicare Enrollment ID | O20241111002792 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831789502 | NPI | - | NPPES |
| RSA-02440 | Other | MD | RSA |
| Provider Name | Rasheda Amera Persinger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871922997 PECOS PAC ID: 1355574328 Enrollment ID: I20140428000209 |
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