| Life Line Corporation -4 Llc | |
|
2111 Hanover Pike Hampstead MD 21074-1319 | |
| (443) 255-3951 | |
| Not Available |
| Full Name | Life Line Corporation -4 Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2111 Hanover Pike, Hampstead, Maryland |
| Authorized Official Name and Position | Kamal Gordhanbhai Bangoria (OWNER) |
| Authorized Official Contact | 4108482566 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Life Line Corporation -4 Llc 1798 Oden Way Eldersburg MD 21784-7095 Ph: (443) 255-3951 | Life Line Corporation -4 Llc 2111 Hanover Pike Hampstead MD 21074-1319 Ph: (443) 255-3951 |
| NPI Number | 1942099247 |
|---|---|
| Provider Enumeration Date | 05/02/2025 |
| Last Update Date | 05/02/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942099247 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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