Provider Demographics
NPI:1528825304
Name:SHEDRICK FAMILY WELLNESS, INC
Entity type:Organization
Organization Name:SHEDRICK FAMILY WELLNESS, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:BEATRICE
Authorized Official - Middle Name:
Authorized Official - Last Name:SHEDRICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-438-5612
Mailing Address - Street 1:556 CYNWOOD DR STE C
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:MD
Mailing Address - Zip Code:21601-3886
Mailing Address - Country:US
Mailing Address - Phone:667-810-6112
Mailing Address - Fax:
Practice Address - Street 1:556 CYNWOOD DR STE C
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:MD
Practice Address - Zip Code:21601-3886
Practice Address - Country:US
Practice Address - Phone:667-810-6112
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SHEDRICK FAMILY WELLNESS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-02-28
Last Update Date:2024-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
No251S00000XAgenciesCommunity/Behavioral Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No291U00000XLaboratoriesClinical Medical Laboratory