Healthcare Provider Details

I. General information

NPI: 1902086135
Provider Name (Legal Business Name): PDN HEALTH CARE SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/05/2007
Last Update Date: 11/05/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8412 MYRTLE AVE
BOWIE MD
20715-4557
US

IV. Provider business mailing address

8412 MYRTLE AVE
BOWIE MD
20715-4557
US

V. Phone/Fax

Practice location:
  • Phone: 240-334-3504
  • Fax: 240-235-4488
Mailing address:
  • Phone: 240-334-3504
  • Fax: 240-235-4488

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State

VIII. Authorized Official

Name: ADAKU AKOBUNDU
Title or Position: ADMISTRATOR
Credential:
Phone: 240-334-3504