| Citadel Services Llc | |
|
2105 Belfry Ln Bowie MD 20721-2253 | |
| (240) 695-4844 | |
| Not Available |
| Full Name | Citadel Services Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 2105 Belfry Ln, Bowie, Maryland |
| Authorized Official Name and Position | Aminata Bangura (OWNER) |
| Authorized Official Contact | 2406954844 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Citadel Services Llc 2105 Belfry Ln Bowie MD 20721-2253 Ph: (240) 695-4844 | Citadel Services Llc 2105 Belfry Ln Bowie MD 20721-2253 Ph: (240) 695-4844 |
| NPI Number | 1053908046 |
|---|---|
| Provider Enumeration Date | 12/24/2020 |
| Last Update Date | 01/17/2024 |
| Certification Date | 01/12/2024 |
| Medicare PECOS PAC ID | 6103232475 |
|---|---|
| Medicare Enrollment ID | O20210311000129 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053908046 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Aminata Bangura |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740841030 PECOS PAC ID: 5991036469 Enrollment ID: I20210311000164 |
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