| Kolossal Healthcare Services | |
|
822 Guilford Ave Unit 2010 Baltimore MD 21202-3707 | |
| (240) 869-7939 | |
| Not Available |
| Full Name | Kolossal Healthcare Services |
|---|---|
| Speciality | Clinic/Center |
| Location | 822 Guilford Ave Unit 2010, Baltimore, Maryland |
| Authorized Official Name and Position | Kofo Abiru-adebambo (CEO / OWNER) |
| Authorized Official Contact | 2408697939 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kolossal Healthcare Services 822 Guilford Ave # 2010 Baltimore MD 21202-3707 Ph: (240) 869-7939 | Kolossal Healthcare Services 822 Guilford Ave Unit 2010 Baltimore MD 21202-3707 Ph: (240) 869-7939 |
| NPI Number | 1013448760 |
|---|---|
| Provider Enumeration Date | 03/24/2017 |
| Last Update Date | 04/11/2023 |
| Certification Date | 04/11/2023 |
| Medicare PECOS PAC ID | 7315306347 |
|---|---|
| Medicare Enrollment ID | O20230707003273 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013448760 | NPI | - | NPPES |
| Provider Name | Kofo Abiru-adebambo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548924459 PECOS PAC ID: 9537556725 Enrollment ID: I20220418000432 |
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