Healthcare Provider Details

I. General information

NPI: 1043953888
Provider Name (Legal Business Name): ABIC HEALTHCARE SERVICES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/19/2022
Last Update Date: 05/10/2024
Certification Date: 05/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11238 REISTERSTOWN RD
OWINGS MILLS MD
21117-1900
US

IV. Provider business mailing address

4213 WYNFIELD DR
OWINGS MILLS MD
21117-6171
US

V. Phone/Fax

Practice location:
  • Phone: 443-790-4021
  • Fax: 866-413-1056
Mailing address:
  • Phone: 443-790-4021
  • Fax: 866-413-1056

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: VIVIAN IFEOMA UDOMA
Title or Position: ADMINISTRATOR
Credential: LPN
Phone: 443-790-4021