Longevity Health Park
Clinic/Center in Rockville, MD. Organization (NPI-2).
NPI number1184307704
StatusActive
Last updated in NPPESAug 10, 2023
Details
- NPI
- 1184307704
- Entity type
- Organization (NPI-2)
- Legal business name
- Longevity Health Park
- Organization subpart
- No
- Enumeration date
- Aug 10, 2023
- Certification date
- Aug 10, 2023
- Last updated
- Aug 10, 2023
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261Q00000X | Clinic/Center | – | – | Yes |
Other names
- Longevity Health Infusions/Incontrol (Doing Business As)
Practice location
110 N Washington St Ste 115Rockville, MD 20850-2223
Phone 301-291-5828
Mailing address
110 N Washington St Ste 115Rockville, MD 20850-2223
Phone 301-291-5828
Authorized official
Kristina Lovelace-Bailey
Managing Partner
9178058922
Is something wrong?
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