Provider Demographics
NPI:1225522618
Name:ICARE HEALTH SERVICES
Entity Type:Organization
Organization Name:ICARE HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:EBERECHUKWU
Authorized Official - Middle Name:
Authorized Official - Last Name:NWAOGU
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-BC
Authorized Official - Phone:301-300-8624
Mailing Address - Street 1:14502 GREENVIEW DR STE 300A
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20708-4247
Mailing Address - Country:US
Mailing Address - Phone:301-300-8624
Mailing Address - Fax:
Practice Address - Street 1:14502 GREENVIEW DR STE 108
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20708-4233
Practice Address - Country:US
Practice Address - Phone:301-300-8624
Practice Address - Fax:240-614-2750
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-19
Last Update Date:2021-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service