MEDICARE: K&I HEALTHCARE SERVICES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QC1500X	Community Health Clinic/Center
2	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1902485683
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	K&I HEALTHCARE SERVICES

Provider Business Mailing Address
First Line	:	4301 GARDEN CITY DR STE 303
Second Line	:
City	:	LANDOVER
State	:	MD
Zip	:	20785-6105
Country	:	US
Telephone Number	:	240-667-1679
Fax Number	:	240-667-1712

Provider Business Practice Location Address
First Line	:	4301 GARDEN CITY DR STE 303
Second Line	:
City	:	LANDOVER
State	:	MD
Zip	:	20785-6105
Country	:	US
Telephone Number	:	240-667-1679
Fax Number	:	240-667-1712

Authorized Official
Title or Position	:	CEO
Name	:	IKECHUKWU OBIORA
Credential	:
Telephone Number	:	517-214-3258

Provider Enumeration Date	:	04/07/2021
Last Update Date	:	04/07/2021

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Directions to “K&I HEALTHCARE SERVICES ” Practice Location

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