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:240-478-4938
Mailing Address - Street 1:12308 EUGENES PROSPECT DR
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20720-3372
Mailing Address - Country:US
Mailing Address - Phone:240-478-4938
Mailing Address - Fax:
Practice Address - Street 1:12308 EUGENES PROSPECT DR
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20720-3372
Practice Address - Country:US
Practice Address - Phone:240-478-4938
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-28
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Multi-Specialty
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatricsGroup - Multi-Specialty