Healthcare Provider Details

I. General information

NPI: 1043409253
Provider Name (Legal Business Name): PIONEER HOMECARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2007
Last Update Date: 08/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6281 LOVEKNOT PL SUITE 200
COLUMBIA MD
21045-4512
US

IV. Provider business mailing address

6281 LOVEKNOT PL SUITE 200
COLUMBIA MD
21045-4512
US

V. Phone/Fax

Practice location:
  • Phone: 443-280-2407
  • Fax: 443-283-0377
Mailing address:
  • Phone: 443-280-2407
  • Fax: 443-283-0377

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberR2486
License Number StateMD

VIII. Authorized Official

Name: MRS. MERCY EBERE IJOMA
Title or Position: ADMINISTRATOR
Credential: RN
Phone: 443-280-2407