Work Life Primary Care LLC
Clinic/Center, Primary Care in Glen Burnie, MD. Organization (NPI-2).
NPI number1669912259
StatusActive
Last updated in NPPESMar 1, 2017
Details
- NPI
- 1669912259
- Entity type
- Organization (NPI-2)
- Legal business name
- Work Life Primary Care LLC
- Organization subpart
- No
- Enumeration date
- Mar 1, 2017
- Last updated
- Mar 1, 2017
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QP2300X | Clinic/Center, Primary Care | C03263 | MD | Yes |
Practice location
7954 Baltimore Annapolis BlvdSuite 2-C
Glen Burnie, MD 21060-8188
Phone 410-487-6052 · Fax 443-960-4203
Mailing address
7954 Baltimore Annapolis BlvdSuite 2-C
Glen Burnie, MD 21060-8188
Phone 410-487-6052 · Fax 443-960-4203
Authorized official
Bamoyo Nkongolo
Owner
3025629437
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