Healthcare Provider Details

I. General information

NPI: 1124654652
Provider Name (Legal Business Name): SEAMAGTEK HEALTHCARE SERVICES, L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/16/2020
Last Update Date: 07/05/2022
Certification Date: 07/05/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4600 POWDER MILL RD STE 450-W
BELTSVILLE MD
20705-2675
US

IV. Provider business mailing address

13807 CLARKWOOD LN
LAUREL MD
20707-9437
US

V. Phone/Fax

Practice location:
  • Phone: 240-349-6300
  • Fax: 979-606-0062
Mailing address:
  • Phone: 240-264-8120
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code363LC1500X
TaxonomyCommunity Health Nurse Practitioner
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number StateNULL
# 5
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number
License Number StateNULL
# 6
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number StateNULL
# 7
Primary TaxonomyN
Taxonomy Code163WA0400X
TaxonomyAddiction (Substance Use Disorder) Registered Nurse
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. ERNESTINE M ENOHMBI
Title or Position: PARTNER
Credential: DNP, CRNP-FAMILY, CR
Phone: 240-349-6300