| Kenah One Health Care Services, Llc | |
|
7310 Ritchie Hwy Ste 612 Glen Burnie MD 21061-3291 | |
| (443) 491-7854 | |
| (443) 288-4808 |
| Full Name | Kenah One Health Care Services, Llc |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 7310 Ritchie Hwy Ste 612, Glen Burnie, Maryland |
| Authorized Official Name and Position | Kulvinder Singh Basra (OFFICE MANAGER) |
| Authorized Official Contact | 2409494886 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kenah One Health Care Services, Llc 7735 Hollins Chapel Ct Glen Burnie MD 21060-8396 Ph: (443) 491-7854 | Kenah One Health Care Services, Llc 7310 Ritchie Hwy Ste 612 Glen Burnie MD 21061-3291 Ph: (443) 491-7854 |
| NPI Number | 1790329530 |
|---|---|
| Provider Enumeration Date | 11/05/2019 |
| Last Update Date | 02/18/2025 |
| Certification Date | 02/18/2025 |
| Medicare PECOS PAC ID | 5991135675 |
|---|---|
| Medicare Enrollment ID | O20200716003210 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790329530 | NPI | - | NPPES |
| Provider Name | Ketty M Ngona |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962714204 PECOS PAC ID: 3779756150 Enrollment ID: I20111031000430 |
| Provider Name | Latonya Cotton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679877609 PECOS PAC ID: 1850511833 Enrollment ID: I20140926000551 |
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Kenah One Health Care Services, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 308 Crain Hwy N, Glen Burnie, MD 21061 Phone: 667-232-1220 Fax: 443-288-4808 | |
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