Provider Demographics
NPI:1619648136
Name:FAITHFIRST HEALTH CLINIC & URGENT CARE LLC
Entity Type:Organization
Organization Name:FAITHFIRST HEALTH CLINIC & URGENT CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:CALISTA
Authorized Official - Middle Name:
Authorized Official - Last Name:OGBU
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:240-334-2520
Mailing Address - Street 1:4302 SAINT BARNABAS RD STE G
Mailing Address - Street 2:
Mailing Address - City:TEMPLE HILLS
Mailing Address - State:MD
Mailing Address - Zip Code:20748-1842
Mailing Address - Country:US
Mailing Address - Phone:240-619-5620
Mailing Address - Fax:800-853-3149
Practice Address - Street 1:4302 SAINT BARNABAS RD STE G
Practice Address - Street 2:
Practice Address - City:TEMPLE HILLS
Practice Address - State:MD
Practice Address - Zip Code:20748-1842
Practice Address - Country:US
Practice Address - Phone:240-619-5620
Practice Address - Fax:800-853-3149
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-23
Last Update Date:2021-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty