Provider Demographics
NPI:1437729761
Name:SHEDRICKFAMILYWELLNESS.INC
Entity Type:Organization
Organization Name:SHEDRICKFAMILYWELLNESS.INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BEATRICE
Authorized Official - Middle Name:
Authorized Official - Last Name:SHEDRICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-509-2159
Mailing Address - Street 1:6628 HARFORD RD FL 1
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21214-1357
Mailing Address - Country:US
Mailing Address - Phone:443-438-5612
Mailing Address - Fax:667-212-4113
Practice Address - Street 1:6628 HARFORD RD FL 1
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21214-1357
Practice Address - Country:US
Practice Address - Phone:443-438-5612
Practice Address - Fax:667-212-4113
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-29
Last Update Date:2021-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health