Healthcare Provider Details

I. General information

NPI: 1154210839
Provider Name (Legal Business Name): METHUSELAH HOSPICE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2025
Last Update Date: 03/14/2026
Certification Date: 03/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16051 COMPRINT CIRCLE
GAITHERSBURG MD
20877-2356
US

IV. Provider business mailing address

4216 EVERGEEN LANE STE 125
ANNANDALE VA
22003-3256
US

V. Phone/Fax

Practice location:
  • Phone: 571-206-1650
  • Fax: 703-662-6165
Mailing address:
  • Phone: 240-284-9501
  • Fax: 240-427-9710

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State

VIII. Authorized Official

Name: JIHO CHOI
Title or Position: OWNER
Credential: MD
Phone: 301-893-4568