Provider Demographics
NPI:1134525678
Name:CAREPOINT DIAGNOSTIC SERVICES, LLC
Entity type:Organization
Organization Name:CAREPOINT DIAGNOSTIC SERVICES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO/DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:GABRIEL
Authorized Official - Middle Name:U
Authorized Official - Last Name:UGWU
Authorized Official - Suffix:
Authorized Official - Credentials:BS,MT,MPH
Authorized Official - Phone:443-527-0001
Mailing Address - Street 1:7416 HARFORD RD
Mailing Address - Street 2:
Mailing Address - City:PARKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21234-7107
Mailing Address - Country:US
Mailing Address - Phone:443-527-0001
Mailing Address - Fax:443-837-6597
Practice Address - Street 1:7416 HARFORD RD
Practice Address - Street 2:
Practice Address - City:PARKVILLE
Practice Address - State:MD
Practice Address - Zip Code:21234-7107
Practice Address - Country:US
Practice Address - Phone:443-527-0001
Practice Address - Fax:443-837-6597
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-11
Last Update Date:2014-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD2181291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD21D2055735Medicaid