Healthcare Provider Details

I. General information

NPI: 1659022085
Provider Name (Legal Business Name): MERCY WANGALIA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/18/2022
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2113 EMMORTON PARK RD STE 102
EDGEWOOD MD
21040-1065
US

IV. Provider business mailing address

2113 EMMORTON PARK RD STE 102
EDGEWOOD MD
21040-1065
US

V. Phone/Fax

Practice location:
  • Phone: 240-470-7047
  • Fax: 240-470-7049
Mailing address:
  • Phone: 240-470-7047
  • Fax: 240-470-7049

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License NumberR4933R
License Number StateMD
# 4
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: