Healthcare Provider Details

I. General information

NPI: 1568326734
Provider Name (Legal Business Name): CHRUCE WEMBEH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/12/2025
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4445 ALABAMA AVE SE
WASHINGTON DC
20019-5734
US

IV. Provider business mailing address

4445 ALABAMA AVE SE
WASHINGTON DC
20019-5734
US

V. Phone/Fax

Practice location:
  • Phone: 240-940-7905
  • Fax:
Mailing address:
  • Phone: 240-940-7905
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberHHA200005387
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: