| Primal Point Llc | |
|
8713 Harford Rd Ste 102 Parkville MD 21234-4650 | |
| (410) 870-1590 | |
| Not Available |
| Full Name | Primal Point Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 8713 Harford Rd Ste 102, Parkville, Maryland |
| Authorized Official Name and Position | Jane W Mwangi (PRESIDENT) |
| Authorized Official Contact | 4108701590 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Primal Point Llc 8713 Harford Rd Ste 102 Parkville MD 21234-4650 Ph: (410) 870-1590 | Primal Point Llc 8713 Harford Rd Ste 102 Parkville MD 21234-4650 Ph: (410) 870-1590 |
| NPI Number | 1114691672 |
|---|---|
| Provider Enumeration Date | 08/06/2021 |
| Last Update Date | 08/06/2021 |
| Certification Date | 08/06/2021 |
| Medicare PECOS PAC ID | 8820494958 |
|---|---|
| Medicare Enrollment ID | O20210915000015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114691672 | NPI | - | NPPES |
| Provider Name | Jane Wanjira Mwangi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699107250 PECOS PAC ID: 4385070333 Enrollment ID: I20200211000611 |
| Provider Name | Ngufor Fube Divine |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669197208 PECOS PAC ID: 1557767688 Enrollment ID: I20221209000420 |
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