Provider Demographics
NPI:1225488240
Name:HARFORD HEALTH CENTER LLC
Entity Type:Organization
Organization Name:HARFORD HEALTH CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DESMOND
Authorized Official - Middle Name:
Authorized Official - Last Name:PINELLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-900-0079
Mailing Address - Street 1:522 N HICKORY AVE
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014-3229
Mailing Address - Country:US
Mailing Address - Phone:443-900-0079
Mailing Address - Fax:
Practice Address - Street 1:522 N HICKORY AVE
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-3229
Practice Address - Country:US
Practice Address - Phone:443-900-0079
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-21
Last Update Date:2016-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDS01590174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty