Healthcare Provider Details

I. General information

NPI: 1285042101
Provider Name (Legal Business Name): OBIMEM CARING HAND LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2014
Last Update Date: 08/18/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1055 TAYLOR AVE STE 208
BALTIMORE MD
21286-8333
US

IV. Provider business mailing address

1055 TAYLOR AVE STE 208
BALTIMORE MD
21286-8333
US

V. Phone/Fax

Practice location:
  • Phone: 410-419-3358
  • Fax: 410-853-7604
Mailing address:
  • Phone: 410-419-3358
  • Fax: 410-853-7604

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License NumberR3584R
License Number StateMD

VIII. Authorized Official

Name: MR. ANDREW EMEKA OBIEFULE SR.
Title or Position: ADMINISTRATOR
Credential: LPN
Phone: 410-419-3358