Ciwo Healthcare Services | |
10100 Balsamwood Dr Laurel MD 20708-3152 | |
(973) 866-7691 | |
Not Available |
Full Name | Ciwo Healthcare Services |
---|---|
Speciality | Clinic/Center |
Location | 10100 Balsamwood Dr, Laurel, Maryland |
Authorized Official Name and Position | Chioma Ejemole (PRESIDENT) |
Authorized Official Contact | 9738667691 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Ciwo Healthcare Services 10100 Balsamwood Dr Laurel MD 20708-3152 Ph: (973) 866-7691 | Ciwo Healthcare Services 10100 Balsamwood Dr Laurel MD 20708-3152 Ph: (973) 866-7691 |
NPI Number | 1548032238 |
---|---|
Provider Enumeration Date | 10/25/2023 |
Last Update Date | 10/25/2023 |
Medicare PECOS PAC ID | 7012364342 |
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Medicare Enrollment ID | O20231108002396 |
Identifier | Type | State | Issuer |
---|---|---|---|
1548032238 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | (* (Not Available)) | Primary |
363LF0000X | Nurse Practitioner - Family | (* (Not Available)) | Secondary |
Provider Name | Chioma Ejemole |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1700359163 PECOS PAC ID: 3476954314 Enrollment ID: I20230406002397 |
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