OrganizationVastcare Medical ClinicNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address9470 Annapolis Rd Ste 115, Lanham, MD 20706-3025(301) 708-0100PECOS EnrollmentBased on the most recent information from CMS, provider Vastcare Medical Clinic does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1356951198Provider TypeOrganizationFull NameVastcare Medical ClinicSubpartNoEnumeration Date8/6/2020Last Updated8/6/2020Contact InformationPractice LocationPractice Address9470 Annapolis Rd Ste 115, Lanham, MD 20706-3025Phone(301) 708-0100Fax(301) 708-0101Mailing LocationMailing Address9470 Annapolis Rd Ste 115, Lanham, MD 20706-3025Phone(301) 708-0100Fax(301) 708-0101Authorized OfficialNameAkpuaka, Stella Obianuju (Np Provider)Phone(301) 708-0100Provider TaxonomiesCodeDescriptionLicenseCode363LP0808XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicenseUnlisted Issuer