Provider Demographics
NPI:1265235030
Name:MERCYLAND HEALTHCARE SERVICES, INC
Entity type:Organization
Organization Name:MERCYLAND HEALTHCARE SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARCELLINUS
Authorized Official - Middle Name:O
Authorized Official - Last Name:NWADIBIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-256-8204
Mailing Address - Street 1:9914 FARM POND RD
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20708-6000
Mailing Address - Country:US
Mailing Address - Phone:240-521-5509
Mailing Address - Fax:240-790-8928
Practice Address - Street 1:6811 KENILWORTH AVE STE 604
Practice Address - Street 2:
Practice Address - City:RIVERDALE
Practice Address - State:MD
Practice Address - Zip Code:20737-1341
Practice Address - Country:US
Practice Address - Phone:240-521-5509
Practice Address - Fax:240-790-8928
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-28
Last Update Date:2025-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health