MEDICARE: P & E COMPASSIONATE CARE, LLC

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	251B00000X	Case Management Agency	RN1009165	DC

General Provider Information

NPI Number	:	1841730967
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	P & E COMPASSIONATE CARE, LLC

Provider Business Mailing Address
First Line	:	4512 DOCTOR BEANS LEGACY CIR
Second Line	:
City	:	BOWIE
State	:	MD
Zip	:	20720-6384
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4512 DOCTOR BEANS LEGACY CIR
Second Line	:
City	:	BOWIE
State	:	MD
Zip	:	20720-6384
Country	:	US
Telephone Number	:	202-257-2130
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	ESABELLA TEBID MBAH
Credential	:	APRN
Telephone Number	:	202-257-2130

Provider Enumeration Date	:	03/08/2017
Last Update Date	:	03/08/2017

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