MEDICARE: BERHAN HOME HEALTH CARE AGENCY INC

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	251E00000X	Home Health Agency	097053	DC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1841386067
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BERHAN HOME HEALTH CARE AGENCY INC

Provider Business Mailing Address
First Line	:	7826 EASTERN AVE NW
Second Line	:	SUITE LL 16
City	:	WASHINGTON
State	:	DC
Zip	:	20012-1324
Country	:	US
Telephone Number	:	202-723-1100
Fax Number	:	202-723-3271

Provider Business Practice Location Address
First Line	:	7826 EASTERN AVE NW
Second Line	:	SUITE LL 16
City	:	WASHINGTON
State	:	DC
Zip	:	20012-1324
Country	:	US
Telephone Number	:	202-723-1100
Fax Number	:	202-723-3271

Authorized Official
Title or Position	:	CEO
Name	:	MR. FESSHA WOLDE MOLLALIGN
Credential	:
Telephone Number	:	202-723-1100

Provider Enumeration Date	:	10/05/2006
Last Update Date	:	09/20/2017

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