Provider Demographics
NPI:1386478782
Name:ACCESS HEALTHCARE AND WELLNESS LLC
Entity type:Organization
Organization Name:ACCESS HEALTHCARE AND WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:IJEOMAH
Authorized Official - Middle Name:
Authorized Official - Last Name:AHAGHOTU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-235-9999
Mailing Address - Street 1:4305 NORTHVIEW DR STE 38
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20716-2600
Mailing Address - Country:US
Mailing Address - Phone:301-235-9999
Mailing Address - Fax:301-235-9950
Practice Address - Street 1:4305 NORTHVIEW DR STE 38
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20716-2600
Practice Address - Country:US
Practice Address - Phone:301-235-9999
Practice Address - Fax:301-235-9950
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-28
Last Update Date:2025-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatricsGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Multi-Specialty