Provider Demographics
NPI:1689336703
Name:MEDFICIENT HEALTH, LLC
Entity Type:Organization
Organization Name:MEDFICIENT HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:RITA
Authorized Official - Middle Name:KIMBLE
Authorized Official - Last Name:OKOBI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-543-7873
Mailing Address - Street 1:11720 BELTSVILLE DR STE 500-A07
Mailing Address - Street 2:
Mailing Address - City:BELTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20705-3166
Mailing Address - Country:US
Mailing Address - Phone:240-543-7873
Mailing Address - Fax:
Practice Address - Street 1:11720 BELTSVILLE DR STE 500-A07
Practice Address - Street 2:
Practice Address - City:BELTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20705-3166
Practice Address - Country:US
Practice Address - Phone:240-543-7873
Practice Address - Fax:240-559-2354
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-06
Last Update Date:2021-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD5258091800Medicaid