Provider Demographics
NPI:1073060349
Name:PHILEX HEALTH SERVICES INC.
Entity Type:Organization
Organization Name:PHILEX HEALTH SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPAL ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:N
Authorized Official - Last Name:NJOKU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-653-6968
Mailing Address - Street 1:2802 UPRIDGE CT
Mailing Address - Street 2:APT F
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21234-4433
Mailing Address - Country:US
Mailing Address - Phone:443-653-6968
Mailing Address - Fax:443-495-7756
Practice Address - Street 1:2802 UPRIDGE CT
Practice Address - Street 2:APT F
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21234-4433
Practice Address - Country:US
Practice Address - Phone:443-653-6968
Practice Address - Fax:443-495-7756
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-05
Last Update Date:2016-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR3920RP253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDR3920RPMedicaid