Healthcare Provider Details

I. General information

NPI: 1013570092
Provider Name (Legal Business Name): ABC HEALTHCARE SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/16/2019
Last Update Date: 04/26/2024
Certification Date: 04/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13013 INNISBROOK DR
BELTSVILLE MD
20705-1195
US

IV. Provider business mailing address

13013 INNISBROOK DR
BELTSVILLE MD
20705-1195
US

V. Phone/Fax

Practice location:
  • Phone: 402-624-6010
  • Fax:
Mailing address:
  • Phone: 678-468-1078
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: BHARAT B MENDPARA
Title or Position: PRESIDENT
Credential: RN
Phone: 420-624-6010