# FARA MEDICAL SERVICES LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1548910060
- **Authorized official:** FARAMADE ERUANGA DNP, PMHNP-BC FNPBC (MEDICAL DIRECTOR)
- **Authorized official phone:** (240) 606-9176

## Contact information

- **Practice address:** 6525 KENOVA ST, DISTRICT HEIGHTS, MD 20747-2835
- **Practice address phone:** (240) 606-9176
- **Mailing address:** 2883 FALKIRK ALY, BRYANS ROAD, MD 20616-7017
- **Mailing address phone:** (240) 606-9176

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LF0000X | Family Nurse Practitioner | — | NULL | — |
| 363LF0000X | Family Nurse Practitioner | — | — | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 03/27/2022
- **Last updated:** 03/27/2022