Provider Demographics
NPI:1184231888
Name:HANEI HEALTH SOLUTIONS, LLC
Entity Type:Organization
Organization Name:HANEI HEALTH SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JUDDY
Authorized Official - Middle Name:
Authorized Official - Last Name:MORGAN
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP
Authorized Official - Phone:786-246-7326
Mailing Address - Street 1:451 N HUNGERFORD DR
Mailing Address - Street 2:STE 119 RM 114
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-5148
Mailing Address - Country:US
Mailing Address - Phone:443-741-2488
Mailing Address - Fax:561-584-7338
Practice Address - Street 1:1420 MERRITT BLVD STE B
Practice Address - Street 2:
Practice Address - City:DUNDALK
Practice Address - State:MD
Practice Address - Zip Code:21222-2192
Practice Address - Country:US
Practice Address - Phone:443-741-2488
Practice Address - Fax:240-306-9325
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-26
Last Update Date:2021-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD600086000Medicaid