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NPI Code Detail

MEDICARE: MS. CAROL LONGMORE

MEDICARE: MS. CAROL LONGMORE
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
13747P1801XPersonal Care Attendant

General Provider Information

NPI Number : 1457138018
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. CAROL LONGMORE
Provider Business Mailing Address
First Line : 4413 ILLINOIS AVE NW
Second Line :
City : WASHINGTON
State : DC
Zip : 20011-4627
Country : US
Telephone Number : 202-725-8473
Fax Number :
Provider Business Practice Location Address
First Line : 4413 ILLINOIS AVE NW
Second Line :
City : WASHINGTON
State : DC
Zip : 20011-4627
Country : US
Telephone Number : 202-725-8473
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/08/2023
Last Update Date : 09/08/2023

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