Healthcare Provider Details

I. General information

NPI: 1194358846
Provider Name (Legal Business Name): AKACHI PRIMARY & URGENT CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2020
Last Update Date: 03/12/2023
Certification Date: 03/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8957 EDMONSTON RD STE P
GREENBELT MD
20770-4048
US

IV. Provider business mailing address

8957 EDMONSTON RD STE P
GREENBELT MD
20770-4048
US

V. Phone/Fax

Practice location:
  • Phone: 609-225-1255
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MERCY ESEME
Title or Position: OWNER
Credential:
Phone: 609-225-1255