Healthcare Provider Details

I. General information

NPI: 1083537807
Provider Name (Legal Business Name): JUPITER HOMEHEALTH CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12321 MIDDLEBROOK RD STE 210
GERMANTOWN MD
20874-1518
US

IV. Provider business mailing address

12321 MIDDLEBROOK RD SUITE#210
GERMANTOWN MD
20874
US

V. Phone/Fax

Practice location:
  • Phone: 301-912-6277
  • Fax: 240-474-0110
Mailing address:
  • Phone: 301-912-6277
  • Fax: 240-474-0110

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: MS. SAPANA Y KHANAL
Title or Position: DIRECTOR OF NURSING
Credential: RN
Phone: 240-930-9050