| Optimum Health Systems, Inc. | |
|
2300 Garrison Blvd Suite 210 Baltimore MD 21216-2335 | |
| (410) 233-6200 | |
| (410) 233-6201 |
| Full Name | Optimum Health Systems, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 2300 Garrison Blvd, Baltimore, Maryland |
| Authorized Official Name and Position | Samson Omotosho (PROGRAM DIRECTOR) |
| Authorized Official Contact | 4438583189 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Optimum Health Systems, Inc. 3709 Collier Rd Randallstown MD 21133-3401 Ph: (410) 233-6200 | Optimum Health Systems, Inc. 2300 Garrison Blvd Suite 210 Baltimore MD 21216-2335 Ph: (410) 233-6200 |
| NPI Number | 1679512073 |
|---|---|
| Provider Enumeration Date | 06/05/2006 |
| Last Update Date | 07/19/2007 |
| Medicare PECOS PAC ID | 8729010228 |
|---|---|
| Medicare Enrollment ID | O20120806000158 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679512073 | NPI | - | NPPES |
| Provider Name | Juhi F Nayeem |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1689767568 PECOS PAC ID: 7214039734 Enrollment ID: I20090106000467 |
| Provider Name | Benjamin O Dahunsi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225535206 PECOS PAC ID: 5193076107 Enrollment ID: I20181001002380 |
| Provider Name | Venus Tomlinson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1548726078 PECOS PAC ID: 9335479625 Enrollment ID: I20190930002690 |
| Provider Name | Benson K Mboche |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699317719 PECOS PAC ID: 5597174466 Enrollment ID: I20210505000868 |
| Provider Name | Michelle Antoinette Goines |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1003389602 PECOS PAC ID: 8628466018 Enrollment ID: I20211104001999 |
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