Individual ProviderIfeyinwa Utoh-OfodileNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address8118 Good Luck Rd, Lanham, MD 20706-3574(646) 714-9708PECOS EnrollmentBased on the most recent information from CMS, provider Ifeyinwa Utoh-Ofodile is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1285364612Provider TypeIndividualFull NameUtoh-Ofodile, IfeyinwaGenderFemaleSole ProprietorYesEnumeration Date6/17/2022Last Updated6/17/2022Contact InformationPractice LocationPractice Address8118 Good Luck Rd, Lanham, MD 20706-3574Phone(646) 714-9708FaxUnlisted FaxMailing LocationMailing Address8118 Good Luck Rd, Lanham, MD 20706-3574PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363LP0808XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicenseR205272Maryland