Provider Demographics
NPI:1205426202
Name:A&B HEALTHCARE SERVICES LLC
Entity type:Organization
Organization Name:A&B HEALTHCARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ABRAHAM
Authorized Official - Middle Name:
Authorized Official - Last Name:MBANGOWAH
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP
Authorized Official - Phone:240-481-6178
Mailing Address - Street 1:15004 PEARTREE DR
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20721-3007
Mailing Address - Country:US
Mailing Address - Phone:240-481-6178
Mailing Address - Fax:888-651-4677
Practice Address - Street 1:15004 PEARTREE DR
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20721-3007
Practice Address - Country:US
Practice Address - Phone:240-481-6178
Practice Address - Fax:888-651-4677
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-22
Last Update Date:2022-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDR202296OtherSTATE LICENSE