Provider Demographics
NPI:1043409253
Name:PIONEER HOMECARE
Entity Type:Organization
Organization Name:PIONEER HOMECARE
Other - Org Name:PIONEER HEALTH SERVICES INC
Other - Org Type:Other Name
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MERCY
Authorized Official - Middle Name:EBERE
Authorized Official - Last Name:IJOMA
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:443-280-2407
Mailing Address - Street 1:6281 LOVEKNOT PL
Mailing Address - Street 2:SUITE 200
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21045-4512
Mailing Address - Country:US
Mailing Address - Phone:443-280-2407
Mailing Address - Fax:443-283-0377
Practice Address - Street 1:6281 LOVEKNOT PL
Practice Address - Street 2:SUITE 200
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-4512
Practice Address - Country:US
Practice Address - Phone:443-280-2407
Practice Address - Fax:443-283-0377
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-24
Last Update Date:2008-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR2486251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD=========OtherEMPLOYER IDENTIFICATION #