Healthcare Provider Details

I. General information

NPI: 1558908335
Provider Name (Legal Business Name): MEDICALINCS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/29/2019
Last Update Date: 11/29/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8757 GEORGIA AVE STE 440
SILVER SPRING MD
20910-3750
US

IV. Provider business mailing address

9710 TRAVILLE GATEWAY DR STE 145
ROCKVILLE MD
20850-7408
US

V. Phone/Fax

Practice location:
  • Phone: 240-800-6303
  • Fax:
Mailing address:
  • Phone: 256-648-9182
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: DR. NKEM OKEKE
Title or Position: PRESIDENT & CEO
Credential: MD, MPH, MBA
Phone: 256-648-9182