Healthcare Provider Details

I. General information

NPI: 1467546226
Provider Name (Legal Business Name): SPEQTRUM INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3019 GEORGIA AVE NW
WASHINGTON DC
20001-3807
US

IV. Provider business mailing address

3019 GEORGIA AVE NW
WASHINGTON DC
20001-3807
US

V. Phone/Fax

Practice location:
  • Phone: 202-797-9444
  • Fax: 202-797-9022
Mailing address:
  • Phone: 202-797-9444
  • Fax: 202-797-9022

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number03-0-1
License Number StateDC

VIII. Authorized Official

Name: MS. PAULINE CHINASA NNAWUBA
Title or Position: PRESIDENT/ADMINISTRATOR
Credential:
Phone: 202-797-9444