Healthcare Provider Details

I. General information

NPI: 1689785347
Provider Name (Legal Business Name): BELTWAY NURSING SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7412 GEORGIA AVE NW SUITE # 3
WASHINGTON DC
20012-1754
US

IV. Provider business mailing address

7412 GEORGIA AVE NW SUITE # 3
WASHINGTON DC
20012-1754
US

V. Phone/Fax

Practice location:
  • Phone: 202-541-9500
  • Fax:
Mailing address:
  • Phone: 202-541-9500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberCON 0305
License Number StateDC

VIII. Authorized Official

Name: MR. ABAYOMI TOMORI AJIBOLA
Title or Position: ADMINISTRATOR
Credential:
Phone: 202-541-9500