Provider Demographics
NPI:1003316407
Name:P&A HEALTH SERVICES LLC
Entity Type:Organization
Organization Name:P&A HEALTH SERVICES LLC
Other - Org Name:P&A HEALTH SERVICES LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:C
Authorized Official - Last Name:ONUOHA EJIOGU
Authorized Official - Suffix:
Authorized Official - Credentials:DO,ND,PRM,PHDS-LEHP
Authorized Official - Phone:410-841-8149
Mailing Address - Street 1:404 S CAMP MEADE RD
Mailing Address - Street 2:
Mailing Address - City:LINTHICUM
Mailing Address - State:MD
Mailing Address - Zip Code:21090-2744
Mailing Address - Country:US
Mailing Address - Phone:410-841-8149
Mailing Address - Fax:
Practice Address - Street 1:404 S CAMP MEADE RD
Practice Address - Street 2:
Practice Address - City:LINTHICUM
Practice Address - State:MD
Practice Address - Zip Code:21090-2744
Practice Address - Country:US
Practice Address - Phone:410-841-8149
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-13
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251B00000X, 251K00000X, 261QR0400X, 261QR1100X, 302R00000X, 332900000X
PA03595628251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1100XAmbulatory Health Care FacilitiesClinic/CenterResearch
No251B00000XAgenciesCase Management
No251K00000XAgenciesPublic Health or Welfare
No261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
No302R00000XManaged Care OrganizationsHealth Maintenance Organization
No332900000XSuppliersNon-Pharmacy Dispensing Site
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA03595628OtherAMERICAN COLLEGE OF PHYSICIAN
NPSOtherPHLEBOTOMY AND GENERAL SAMPLE COLLECTOR
VABCMMHC-817OtherMENTAL HEALTH COACH
LEHP-1069OtherWELLNESS, LIFESTYLE AND HOLISTIC SERVICES
39110-1665410715OtherCERTIFIED BEHAVIOR SPECIALIST
FL22464034OtherIBCCES
AADP-240061104OtherHOLISTIC HEALTH PRACTITIONER
AANWPOtherNAPRAPATHY AND OSTEOPATHIC MANUAL PRACTITIONER