Healthcare Provider Details

I. General information

NPI: 1558051078
Provider Name (Legal Business Name): HUBCITY HEALTHCARE & SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2023
Last Update Date: 05/09/2023
Certification Date: 05/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1908 LONDONTOWNE DR
HAGERSTOWN MD
21740-6735
US

IV. Provider business mailing address

1908 LONDONTOWNE DR
HAGERSTOWN MD
21740-6735
US

V. Phone/Fax

Practice location:
  • Phone: 240-938-6362
  • Fax:
Mailing address:
  • Phone: 240-938-6362
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TA0700X
TaxonomyAdult Development & Aging Psychologist
License Number
License Number State

VIII. Authorized Official

Name: MS. PAMELA OWUSU
Title or Position: COO
Credential: CF
Phone: 240-938-6362