Provider Demographics
NPI:1194225532
Name:PAX HEALTH GROUP
Entity Type:Organization
Organization Name:PAX HEALTH GROUP
Other - Org Name:PAX HEALTH GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ISAAC
Authorized Official - Middle Name:
Authorized Official - Last Name:OLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-520-3354
Mailing Address - Street 1:7565 STONEY RUN DR APT G
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:MD
Mailing Address - Zip Code:21076-1464
Mailing Address - Country:US
Mailing Address - Phone:443-520-3354
Mailing Address - Fax:
Practice Address - Street 1:7565 STONEY RUN DR APT G
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:MD
Practice Address - Zip Code:21076-1464
Practice Address - Country:US
Practice Address - Phone:443-520-3354
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-12
Last Update Date:2018-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD251E00000X
251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health