OrganizationChivic Healthcare Services LlcNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address9470 Annapolis Rd Ste 416, Lanham, MD 20706-3000(202) 735-1010PECOS EnrollmentBased on the most recent information from CMS, provider Chivic Healthcare Services Llc does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records today at 10:04 AM.Profile DetailsProvider ID1730784398Provider TypeOrganizationFull NameChivic Healthcare Services LlcSubpartNoEnumeration Date12/2/2020Last Updated8/17/2023Contact InformationPractice LocationPractice Address9470 Annapolis Rd Ste 416, Lanham, MD 20706-3000Phone(202) 735-1010FaxUnlisted FaxMailing LocationMailing Address7525 Greenway Center Dr Ste 316, Greenbelt, MD 20770-3525Phone(202) 735-1010Fax(202) 567-6361Authorized OfficialNameMbakpuo, Ndidiamaka Ezinne (Managing Director)Phone(301) 712-4637Provider TaxonomiesCodeDescriptionLicenseCode363LP0808XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicenseUnlisted IssuerCode251S00000XDescriptionCommunity/Behavioral HealthAgenciesLicenseUnlisted IssuerCode261Q00000XDescriptionClinic/CenterAmbulatory Health Care FacilitiesLicenseUnlisted IssuerCode261QM1300XDescriptionClinic/CenterAmbulatory Health Care FacilitiesLicenseUnlisted Issuer