| R I C Health Services Llc | |
|
1300 Mercantile Ln Ste 100c Largo MD 20774-5383 | |
| (301) 278-2626 | |
| (497) 986-8609 |
| Full Name | R I C Health Services Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1300 Mercantile Ln Ste 100c, Largo, Maryland |
| Authorized Official Name and Position | Ruphina Nnebedum (OWNER) |
| Authorized Official Contact | 2403742906 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| R I C Health Services Llc 10706 Birdie Ln Upper Marlboro MD 20774-6019 Ph: (240) 493-4704 | R I C Health Services Llc 1300 Mercantile Ln Ste 100c Largo MD 20774-5383 Ph: (301) 278-2626 |
| NPI Number | 1124775861 |
|---|---|
| Provider Enumeration Date | 03/02/2022 |
| Last Update Date | 07/08/2022 |
| Certification Date | 07/08/2022 |
| Medicare PECOS PAC ID | 6800282567 |
|---|---|
| Medicare Enrollment ID | O20220405001863 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124775861 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Ruphina Ogechi Nnebedum |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417455932 PECOS PAC ID: 5597153338 Enrollment ID: I20211027000762 |
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