Healthcare Provider Details

I. General information

NPI: 1881848356
Provider Name (Legal Business Name): PMF CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/11/2008
Last Update Date: 11/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4230 EADS ST NE
WASHINGTON DC
20017
US

IV. Provider business mailing address

10300 FOXLAKE DR
MITCHELLVILLE MD
20721-2607
US

V. Phone/Fax

Practice location:
  • Phone: 240-355-5398
  • Fax:
Mailing address:
  • Phone: 240-355-5398
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD1600X
TaxonomyDevelopmental Disabilities Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. MUTED FOFUNG
Title or Position: PRESIDENT/CEO
Credential:
Phone: 240-355-5398