Basic Information
| Provider Information | |||||||||
| NPI: | 1700971280 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | I CARE INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8909 OLD BRANCH AVE | ||||||||
| Address2: | |||||||||
| City: | CLINTON | ||||||||
| State: | MD | ||||||||
| PostalCode: | 20735 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3018687274 | ||||||||
| FaxNumber: | 3018614671 | ||||||||
| Practice Location | |||||||||
| Address1: | 100 HOSPITAL DRIVE | ||||||||
| Address2: | |||||||||
| City: | PRINCE FREDERICK | ||||||||
| State: | MD | ||||||||
| PostalCode: | 20678 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3018687274 | ||||||||
| FaxNumber: | 3018614367 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/03/2006 | ||||||||
| LastUpdateDate: | 07/27/2007 | ||||||||
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| AuthorizedOfficialLastName: | MILLER | ||||||||
| AuthorizedOfficialFirstName: | MARYANN | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | PRAC ADMIN | ||||||||
| AuthorizedOfficialTelephone: | 3018687274 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | Y | 193200000X MULTI-SPECIALTY GROUP | Other Service Providers | Specialist |
No ID Information.