Healthcare Provider Details

I. General information

NPI: 1275704629
Provider Name (Legal Business Name): MAGNIFICUS CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2008
Last Update Date: 03/13/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

37 L ST SE
WASHINGTON DC
20003-3331
US

IV. Provider business mailing address

37 L ST SE
WASHINGTON DC
20003-3331
US

V. Phone/Fax

Practice location:
  • Phone: 202-484-6242
  • Fax: 202-484-6243
Mailing address:
  • Phone: 202-484-6242
  • Fax: 202-484-6243

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License NumberNSA-0044
License Number StateDC

VIII. Authorized Official

Name: AKINTOYE O SHOETAN
Title or Position: PRESIDENT/CEO
Credential:
Phone: 202-484-6242