Provider Demographics
NPI:1780278614
Name:CMAG HEALTH SOLUTIONS, LLC
Entity type:Organization
Organization Name:CMAG HEALTH SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:IVY
Authorized Official - Last Name:GUSTUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-517-2624
Mailing Address - Street 1:11155 DOLFIELD BLVD STE 110
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-3289
Mailing Address - Country:US
Mailing Address - Phone:410-517-2624
Mailing Address - Fax:
Practice Address - Street 1:11155 DOLFIELD BLVD STE 110
Practice Address - Street 2:
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-3289
Practice Address - Country:US
Practice Address - Phone:410-517-2624
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CMAG HEALTH SOLUTIONS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-02-22
Last Update Date:2021-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
No163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty
No163WW0000XNursing Service ProvidersRegistered NurseWound CareGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty