OrganizationShady Grove Children'S Gad, LlcAnesthesiologyAllopathic & Osteopathic PhysiciansPractice Address15001 Shady Grove Rd, Rockville, MD 20850-6352(301) 307-3333(301) 494-3000PECOS EnrollmentBased on the most recent information from CMS, provider Shady Grove Children'S Gad, Llc 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 8 days ago.Profile DetailsProvider ID1184461063Provider TypeOrganizationFull NameShady Grove Children'S Gad, LlcSubpartNoEnumeration Date7/9/2024Last Updated9/11/2024Contact InformationPractice LocationPractice Address15001 Shady Grove Rd, Rockville, MD 20850-6352Phone(301) 307-3333Fax(301) 307-5555Mailing LocationMailing Address1220 Caraway Ct Ste 1050, Upper Marlboro, MD 20774-5338Phone(301) 494-3000FaxUnlisted FaxAuthorized OfficialNameWheeler, Jeffrey (Ceo)Phone(301) 494-3000Provider TaxonomiesCodeDescriptionLicenseCode207L00000XPrimaryDescriptionAnesthesiologyAllopathic & Osteopathic PhysiciansLicenseUnlisted IssuerCode367500000XDescriptionNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing ProvidersLicenseUnlisted Issuer