MEDICARE: PBA ASSOCIATES, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center	905143	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1477957439
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PBA ASSOCIATES, INC

Provider Business Mailing Address
First Line	:	115 N MONROE ST
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21223-1641
Country	:	US
Telephone Number	:	443-708-4391
Fax Number	:	443-708-4436

Provider Business Practice Location Address
First Line	:	115 N MONROE ST
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21223-1641
Country	:	US
Telephone Number	:	443-708-4391
Fax Number	:	443-708-4436

Authorized Official
Title or Position	:	PROGRAM DIRECTOR
Name	:	MR. ARNIE E AKPAN
Credential	:
Telephone Number	:	443-708-4391

Provider Enumeration Date	:	10/20/2014
Last Update Date	:	10/20/2014

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Directions to “PBA ASSOCIATES, INC ” Practice Location

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