| First Health Services Llc | |
|
4411 Southern Ave Capitol Heights MD 20743-5639 | |
| (249) 615-6881 | |
| Not Available |
| Full Name | First Health Services Llc |
|---|---|
| Speciality | Counselor |
| Location | 4411 Southern Ave, Capitol Heights, Maryland |
| Authorized Official Name and Position | Stanislus Eban (CEO) |
| Authorized Official Contact | 2406156881 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| First Health Services Llc 433 Old Mill Rd Millersville MD 21108-1039 Ph: (240) 615-6881 | First Health Services Llc 4411 Southern Ave Capitol Heights MD 20743-5639 Ph: (249) 615-6881 |
| NPI Number | 1669055091 |
|---|---|
| Provider Enumeration Date | 05/03/2021 |
| Last Update Date | 05/03/2021 |
| Certification Date | 05/03/2021 |
| Medicare PECOS PAC ID | 4587009642 |
|---|---|
| Medicare Enrollment ID | O20240228002048 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669055091 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Fulgentia Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043925035 PECOS PAC ID: 2163887563 Enrollment ID: I20230508000031 |
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