ETHOS HEALTH MARYLAND 1, LLC (NPI# 1144888025) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1144888025 |
Entity Type | Organization |
Organization Name | ETHOS HEALTH MARYLAND 1, LLC |
Practice Address |
4940 Campbell Blvd Ste 130 Nottingham MD 21236-5910 |
Mailing Address |
1541 Se 17th St Ocala FL 34471-4607 |
Practice Telephone | 4108706498 |
Practice Fax Number | 4108706555 |
Mailing Telephone | 3527325590 |
Mailing Fax Number | 3527320292 |
Enumeration Date | 2019-06-05 |
Last Update Date | 2019-07-19 |
Authorized Official Name | JONATHAN RAY WALKER (OWNER) |
Authorized Official Telephone | 3527325590 |
Authorized Official Credential | DC |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities |
Street Address |
4940 CAMPBELL BLVD STE 130 |
City | NOTTINGHAM |
State | MD |
Zip Code | 21236-5910 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1699381467 | Monique Gaston | Counselor | Well Life Counseling and Consulting, 9649 Belair Road, Ste. 104, Nottingham, MD 21236 | 2020-09-17 |
1215575519 | Bh Brightview Perry Hall Opco, LLC | Alzheimer Center (Dementia Center) | 9657 Belair Road, Nottingham, MD 21236 | 2019-12-17 |
1750929493 | Bh Brightview White Marsh Opco, LLC | Alzheimer Center (Dementia Center) | 8100 Rossville Blvd., Baltimore, MD 21236 | 2019-12-12 |
1083257646 | Matthew Peter Halstad | Behavioral Analyst | 8090 Sandpiper Circle, Nottingham, MD 21236 | 2019-10-25 |
1609331602 | Tunisia Buise | Social Worker | 4132 E. Joppa Road Ste. 110-#1248, Baltimore, MD 21236 | 2019-02-04 |
1730673047 | Golden Jemz Adult Medical Day | Clinic/Center | 5020 Cambell Blvd, Nottingham, MD 21236 | 2018-06-20 |
1487143400 | For Eyes Optical of Pa | Eyewear Supplier (Equipment, not the service) | 7984 Honeygo Blvd, Nottingham, MD 21236 | 2018-05-04 |
1619478922 | Weis Markets, Inc. | Pharmacy | 7927 Belair Rd Ste S, Nottingham, MD 21236 | 2018-02-22 |
1285133918 | Joan Rosa Keller | Behavior Technician | 3501 Taylor Ave., Baltimore, MD 21236 | 2018-02-08 |
1205341146 | Ebony Watkins | Nurse Practitioner | 8940 Kilkenny Circle, Nottingham, MD 21236 | 2017-12-13 |
Find all providers in zip 21236 |
Taxonomy Code | 261QM1300X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Multi-Specialty |
Definition to come... |
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1639664683 | The Heard Group, LLC | Clinic/Center | 6284 Hard Bargain Cir, Indian Head, MD 20640 | 2018-06-22 |
1912407891 | Adoni Healthcare Services, LLC | Clinic/Center | 7525 Greenway Center Dr Ste 316, Greenbelt, MD 20770 | 2018-02-16 |
Find all providers with the same taxonomy |
City | NOTTINGHAM |
Zip Code | 21236 |
Please comment or provide details below to improve the information on ETHOS HEALTH MARYLAND 1, LLC.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.