| Healthy Highways Llc | |
|
19101 Willow Grove Rd Olney MD 20832-1232 | |
| (667) 678-3872 | |
| Not Available |
| Full Name | Healthy Highways Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 19101 Willow Grove Rd, Olney, Maryland |
| Authorized Official Name and Position | Gloria Izore (BUSINESS OWNER) |
| Authorized Official Contact | 6676783872 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Healthy Highways Llc 10500 Little Patuxent Pkwy # 1213 Columbia MD 21044-3585 Ph: () - | Healthy Highways Llc 19101 Willow Grove Rd Olney MD 20832-1232 Ph: (667) 678-3872 |
| NPI Number | 1710747316 |
|---|---|
| Provider Enumeration Date | 03/20/2024 |
| Last Update Date | 03/20/2024 |
| Medicare PECOS PAC ID | 8729516968 |
|---|---|
| Medicare Enrollment ID | O20250115002022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710747316 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Gloria Izore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831725993 PECOS PAC ID: 4981098159 Enrollment ID: I20250115002058 |
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