| Icare Health Services Llc | |
|
5222 W Glendale Ave Glendale AZ 85301-2604 | |
| (623) 303-3813 | |
| Not Available |
| Full Name | Icare Health Services Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 5222 W Glendale Ave, Glendale, Arizona |
| Authorized Official Name and Position | Victoria Fabuluje (PRESIDENT/CEO) |
| Authorized Official Contact | 2027172541 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Icare Health Services Llc 3006 W Donner Dr Phoenix AZ 85041-6345 Ph: (202) 717-2541 | Icare Health Services Llc 5222 W Glendale Ave Glendale AZ 85301-2604 Ph: (623) 303-3813 |
| NPI Number | 1740026947 |
|---|---|
| Provider Enumeration Date | 07/08/2024 |
| Last Update Date | 07/25/2024 |
| Certification Date | 07/25/2024 |
| Medicare PECOS PAC ID | 6901346337 |
|---|---|
| Medicare Enrollment ID | O20240911003323 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740026947 | NPI | - | NPPES |
| Provider Name | Odilia S Kwateng |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629317185 PECOS PAC ID: 8224275375 Enrollment ID: I20130508000352 |
| Provider Name | Rosine Ndayikeze Oriabure |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083268874 PECOS PAC ID: 3274863105 Enrollment ID: I20190919001318 |
| Provider Name | Olajumoke Jongbo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881262509 PECOS PAC ID: 2567826936 Enrollment ID: I20230919000719 |
| Provider Name | Olayemi Bolarinwa |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376006460 PECOS PAC ID: 9638569700 Enrollment ID: I20241004001404 |
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