| Gambrills Sisters Health Care | |
|
106 Calumet Ct Gambrills MD 21054-1060 | |
| (240) 437-2705 | |
| Not Available |
| Full Name | Gambrills Sisters Health Care |
|---|---|
| Speciality | Clinic/Center |
| Location | 106 Calumet Ct, Gambrills, Maryland |
| Authorized Official Name and Position | Fatu Koroma (OWNER) |
| Authorized Official Contact | 2404372705 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gambrills Sisters Health Care 106 Calumet Ct Gambrills MD 21054-1060 Ph: (240) 437-2705 | Gambrills Sisters Health Care 106 Calumet Ct Gambrills MD 21054-1060 Ph: (240) 437-2705 |
| NPI Number | 1417690439 |
|---|---|
| Provider Enumeration Date | 04/18/2022 |
| Last Update Date | 07/18/2024 |
| Certification Date | 07/18/2024 |
| Medicare PECOS PAC ID | 7517345630 |
|---|---|
| Medicare Enrollment ID | O20220602000296 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417690439 | NPI | - | NPPES |
| R187334 | Other | MD | LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Fatu Koroma |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053955104 PECOS PAC ID: 1153709274 Enrollment ID: I20220602000413 |
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