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General NPI Number Information
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NPI Number | 1417595588
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Entity Type | Organization
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Legal Business Name | CITYWIDE HEALTH CORPORATION
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Dates
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Enumeration Date | 12/19/2019
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Last Update Date | 10/13/2025
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Provider Practice Location Address
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Address Line | 17 WARREN RD STE 20B
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City | PIKESVILLE
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State | MD
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Zip | 21208-5334
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Country | US
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Telephone | 410-484-0036
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Fax | 410-484-8107
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Provider Business Mailing Address
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Address Line | 17 WARREN RD STE 20B
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City | PIKESVILLE
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State | MD
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Zip | 21208-5334
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Country | US
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Telephone | 410-484-0036
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Fax | 410-484-8107
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Authorized Official
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Title or Position | OWNER CEO
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Name | DR. PAMELA PENINA JOHNSON
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Credential |
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Telephone | 410-929-2314
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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