| I C Care Corporation | |
|
1100 Mercantile Ln Suite #135 Largo MD 20774-5380 | |
| (301) 773-9700 | |
| (301) 773-4900 |
| Full Name | I C Care Corporation |
|---|---|
| Speciality | Specialist |
| Location | 1100 Mercantile Ln, Largo, Maryland |
| Authorized Official Name and Position | George Herbert Bone (OWNER) |
| Authorized Official Contact | 3017739700 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| I C Care Corporation 1100 Mercantile Ln Suite #135 Largo MD 20774-5380 Ph: (301) 773-9700 | I C Care Corporation 1100 Mercantile Ln Suite #135 Largo MD 20774-5380 Ph: (301) 773-9700 |
| NPI Number | 1104845361 |
|---|---|
| Provider Enumeration Date | 07/19/2006 |
| Last Update Date | 10/25/2011 |
| Medicare PECOS PAC ID | 5496791212 |
|---|---|
| Medicare Enrollment ID | O20050701000563 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104845361 | NPI | - | NPPES |
| 409341100 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Secondary |
| 174400000X | Specialist | D31069 (Maryland) | Primary |
| Provider Name | Kelson Figaro |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1831128750 PECOS PAC ID: 1759275340 Enrollment ID: I20040416001180 |
| Provider Name | George Bone |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1528028297 PECOS PAC ID: 5496664088 Enrollment ID: I20050701000592 |
| Provider Name | Akila Roberts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942851076 PECOS PAC ID: 9234564451 Enrollment ID: I20200116001575 |
| Provider Name | Emelda Che |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134482433 PECOS PAC ID: 2466847157 Enrollment ID: I20220316000192 |
| Provider Name | Yolanda Coleman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528641560 PECOS PAC ID: 7012363773 Enrollment ID: I20231101000703 |
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