MEDICARE: ROBERT JOHNSON

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

General Provider Information

NPI Number	:	1992280135
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT JOHNSON

Provider Business Mailing Address
First Line	:	3100 BELLAMY WAY
Second Line	:
City	:	SUITLAND
State	:	MD
Zip	:	20746-1251
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3550 MINNESOTA AVE SE
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20019-8215
Country	:	US
Telephone Number	:	301-278-5065
Fax Number	:

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

Provider Enumeration Date	:	10/02/2018
Last Update Date	:	10/02/2018

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Directions to “ ROBERT JOHNSON ” Practice Location

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