Healthcare Provider Details

I. General information

NPI: 1033190699
Provider Name (Legal Business Name): OKOJIE HEALTHCARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/10/2005
Last Update Date: 04/09/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1716 SULPHUR SPRING RD
HALETHORPE MD
21227-2538
US

IV. Provider business mailing address

1716 SULPHUR SPRING RD
HALETHORPE MD
21227-2538
US

V. Phone/Fax

Practice location:
  • Phone: 410-242-0750
  • Fax: 410-242-0751
Mailing address:
  • Phone: 410-242-0750
  • Fax: 410-242-0751

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberR2189
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License NumberR2189
License Number StateMD

VIII. Authorized Official

Name: DR. IGUADE GODWIN OKOJIE
Title or Position: PRESIDENT/CEO
Credential: PHARM.D
Phone: 410-242-0750