Healthcare Provider Details

I. General information

NPI: 1932920956
Provider Name (Legal Business Name): HEPATITIS B INITIATIVE OF WASHINGTON DC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/22/2024
Last Update Date: 10/28/2024
Certification Date: 10/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10001 DEREKWOOD LN
LANHAM MD
20706-4804
US

IV. Provider business mailing address

10001 DEREKWOOD LN STE 204-205
LANHAM MD
20706-4804
US

V. Phone/Fax

Practice location:
  • Phone: 202-220-8583
  • Fax: 202-773-0968
Mailing address:
  • Phone: 202-220-8583
  • Fax: 202-773-0968

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: SANDRA ASHFORD
Title or Position: OWNER
Credential:
Phone: 240-462-5834