Provider Demographics
NPI:1255868519
Name:WISECARE, LLC
Entity Type:Organization
Organization Name:WISECARE, LLC
Other - Org Name:WISECARE URGENT CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BETH
Authorized Official - Middle Name:
Authorized Official - Last Name:ECKMAN
Authorized Official - Suffix:
Authorized Official - Credentials:CBCS, CEHRS
Authorized Official - Phone:410-255-7900
Mailing Address - Street 1:33 MAGOTHY BEACH RD STE 102
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:MD
Mailing Address - Zip Code:21122-4465
Mailing Address - Country:US
Mailing Address - Phone:410-255-7900
Mailing Address - Fax:410-255-7300
Practice Address - Street 1:485 RITCHIE HWY STE 102
Practice Address - Street 2:
Practice Address - City:SEVERNA PARK
Practice Address - State:MD
Practice Address - Zip Code:21146-2918
Practice Address - Country:US
Practice Address - Phone:410-255-7900
Practice Address - Fax:410-255-7300
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WISECARE, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-05-17
Last Update Date:2017-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0067662261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care