Provider Demographics
NPI:1083205959
Name:CAPRICORN HEALTH LLC
Entity Type:Organization
Organization Name:CAPRICORN HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:GELMANN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:443-553-0057
Mailing Address - Street 1:101 CHESAPEAKE BLVD STE B
Mailing Address - Street 2:
Mailing Address - City:ELKTON
Mailing Address - State:MD
Mailing Address - Zip Code:21921-6607
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:404 EASTERN BLVD
Practice Address - Street 2:
Practice Address - City:ESSEX
Practice Address - State:MD
Practice Address - Zip Code:21221-6714
Practice Address - Country:US
Practice Address - Phone:443-505-8440
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CAPRICORN HEALTH LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-02-02
Last Update Date:2021-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction MedicineGroup - Single Specialty