Provider Demographics
NPI:1326796970
Name:CHIMARK HEALTHCARE SERVICES LLC
Entity Type:Organization
Organization Name:CHIMARK HEALTHCARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:UZOMA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHIOMA
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP
Authorized Official - Phone:443-743-5998
Mailing Address - Street 1:3732 SENECA GARDEN RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLE RIVER
Mailing Address - State:MD
Mailing Address - Zip Code:21220-7517
Mailing Address - Country:US
Mailing Address - Phone:443-743-5998
Mailing Address - Fax:
Practice Address - Street 1:3732 SENECA GARDEN RD
Practice Address - Street 2:
Practice Address - City:MIDDLE RIVER
Practice Address - State:MD
Practice Address - Zip Code:21220-7517
Practice Address - Country:US
Practice Address - Phone:443-743-5998
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-14
Last Update Date:2022-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health