| Five-star Integrated Health Services, LLC | |
|
1125 West St Annapolis MD 21401-3607 | |
| (667) 204-0614 | |
| Not Available |
| Full Name | Five-star Integrated Health Services, LLC |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 1125 West St, Annapolis, Maryland |
| Authorized Official Name and Position | Tamia D Rollins-musgrave (OWNER) |
| Authorized Official Contact | 4435343652 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Five-star Integrated Health Services, LLC 1125 West St Annapolis MD 21401-3607 Ph: (667) 204-0614 | Five-star Integrated Health Services, LLC 1125 West St Annapolis MD 21401-3607 Ph: (667) 204-0614 |
| NPI Number | 1124596606 |
|---|---|
| Provider Enumeration Date | 11/02/2018 |
| Last Update Date | 08/05/2020 |
| Certification Date | 08/05/2020 |
| Medicare PECOS PAC ID | 6204176878 |
|---|---|
| Medicare Enrollment ID | O20190318001512 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124596606 | NPI | - | NPPES |
| Provider Name | Tamia D Rollins Musgrave |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881962322 PECOS PAC ID: 7315249851 Enrollment ID: I20151230001291 |
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