MEDICARE: EUNICE SMITH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3747P1801X	Personal Care Attendant

General Provider Information

NPI Number	:	1215579255
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EUNICE SMITH

Provider Business Mailing Address
First Line	:	1426 SHADY GLEN DR
Second Line	:
City	:	DISTRICT HEIGHTS
State	:	MD
Zip	:	20747-1714
Country	:	US
Telephone Number	:	202-262-2355
Fax Number	:

Provider Business Practice Location Address
First Line	:	1603 G ST SE
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20003-3132
Country	:	US
Telephone Number	:	202-546-7160
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/10/2019
Last Update Date	:	10/10/2019

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Directions to “ EUNICE SMITH ” Practice Location

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