Healthcare Provider Details

I. General information

NPI: 1942529664
Provider Name (Legal Business Name): OPTIMAL HEALTH CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2010
Last Update Date: 05/06/2020
Certification Date: 05/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11377 ROBINWOOD DR STE 101
HAGERSTOWN MD
21742-6713
US

IV. Provider business mailing address

11377 ROBINWOOD DR STE 101
HAGERSTOWN MD
21742-6713
US

V. Phone/Fax

Practice location:
  • Phone: 301-790-4962
  • Fax: 301-790-4951
Mailing address:
  • Phone: 301-790-4962
  • Fax: 301-790-4951

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License NumberR2865
License Number StateMD

VIII. Authorized Official

Name: JACOB MINANG
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 301-790-4962