Provider Demographics
NPI:1760176622
Name:NATIONAL PIKE HEALTH CENTER, INC.
Entity Type:Organization
Organization Name:NATIONAL PIKE HEALTH CENTER, INC.
Other - Org Name:NATIONAL PIKE HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MRS
Authorized Official - First Name:MOPELOLA
Authorized Official - Middle Name:
Authorized Official - Last Name:OWOYEMI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-375-1540
Mailing Address - Street 1:5411 OLD FREDERICK RD STE 13
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21229-2126
Mailing Address - Country:US
Mailing Address - Phone:410-744-8100
Mailing Address - Fax:
Practice Address - Street 1:700 CORPORATE CENTER CT STE D
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21157-3060
Practice Address - Country:US
Practice Address - Phone:410-375-1540
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-05
Last Update Date:2023-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WP0807XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Child & AdolescentGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral Health
No261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)Group - Multi-Specialty
No364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, AdultGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD230414000OtherPRP