Provider Demographics
NPI:1760250922
Name:POIMANO HEALTHCARE SERVICES
Entity Type:Organization
Organization Name:POIMANO HEALTHCARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SYLVANUS
Authorized Official - Middle Name:BRENYA
Authorized Official - Last Name:MENSAH
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, AGNP
Authorized Official - Phone:443-219-6511
Mailing Address - Street 1:7266 STALLINGS DR
Mailing Address - Street 2:
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21060-8370
Mailing Address - Country:US
Mailing Address - Phone:443-219-6511
Mailing Address - Fax:
Practice Address - Street 1:10705 CHARTER DR STE 420
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044-2800
Practice Address - Country:US
Practice Address - Phone:443-219-6511
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-18
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care