Healthcare Provider Details

I. General information

NPI: 1841952066
Provider Name (Legal Business Name): RITA KIMBLE OKOBI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/06/2021
Last Update Date: 10/06/2021
Certification Date: 10/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11720 BELTSVILLE DR STE 500-A07
BELTSVILLE MD
20705-3166
US

IV. Provider business mailing address

11720 BELTSVILLE DR STE 500-A07
BELTSVILLE MD
20705-3166
US

V. Phone/Fax

Practice location:
  • Phone: 240-543-7873
  • Fax: 240-559-2354
Mailing address:
  • Phone: 240-543-7873
  • Fax: 240-559-2354

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: