Healthcare Provider Details

I. General information

NPI: 1003316407
Provider Name (Legal Business Name): P&A HEALTH SERVICES LIMITED LIABILITY COMPANY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2018
Last Update Date: 11/27/2024
Certification Date: 11/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

404 S CAMP MEADE RD
LINTHICUM MD
21090-2744
US

IV. Provider business mailing address

404 S CAMP MEADE RD
LINTHICUM MD
21090-2744
US

V. Phone/Fax

Practice location:
  • Phone: 410-841-8149
  • Fax:
Mailing address:
  • Phone: 410-841-8149
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number03595628
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code261QR1100X
TaxonomyResearch Clinic/Center
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code302R00000X
TaxonomyHealth Maintenance Organization
License Number
License Number State
# 7
Primary TaxonomyN
Taxonomy Code332900000X
TaxonomyNon-Pharmacy Dispensing Site
License Number
License Number State
# 8
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. PATRICIA C ONUOHA EJIOGU
Title or Position: DIRECTOR/PRESIDENT
Credential: DO,ND,PRM,PHDS-LEHP
Phone: 410-841-8149