| Health Releaf Llc | |
|
1406b Crain Hwy S Ste 304 Glen Burnie MD 21061-4094 | |
| (301) 804-0322 | |
| (240) 266-1052 |
| Full Name | Health Releaf Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1406b Crain Hwy S Ste 304, Glen Burnie, Maryland |
| Authorized Official Name and Position | Shannon Martin (OWNER) |
| Authorized Official Contact | 2406711747 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Health Releaf Llc 1406b Crain Hwy S Ste 304 Glen Burnie MD 21061-4094 Ph: (301) 804-0344 | Health Releaf Llc 1406b Crain Hwy S Ste 304 Glen Burnie MD 21061-4094 Ph: (301) 804-0322 |
| NPI Number | 1235616475 |
|---|---|
| Provider Enumeration Date | 07/20/2018 |
| Last Update Date | 12/19/2022 |
| Medicare PECOS PAC ID | 3971857780 |
|---|---|
| Medicare Enrollment ID | O20181114002271 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235616475 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | R182264 (Maryland) | Primary |
| Provider Name | Shannon Martin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417322926 PECOS PAC ID: 2466758966 Enrollment ID: I20160309001832 |
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