Healthcare Provider Details

I. General information

NPI: 1871224782
Provider Name (Legal Business Name): CAREPATH HEALTH SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/21/2022
Last Update Date: 02/05/2023
Certification Date: 02/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6939 FOX CHASE RD
NEW MARKET MD
21774-6921
US

IV. Provider business mailing address

6939 FOX CHASE RD
NEW MARKET MD
21774-6921
US

V. Phone/Fax

Practice location:
  • Phone: 443-657-3911
  • Fax:
Mailing address:
  • Phone: 443-657-3911
  • Fax:

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 Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MR. ABAYOMI MUTIU BAMGBOSE
Title or Position: CEO
Credential:
Phone: 443-657-3911