Healthcare Provider Details

I. General information

NPI: 1023881075
Provider Name (Legal Business Name): FIDELITY HOME HEALTHCARE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2023
Last Update Date: 11/06/2023
Certification Date: 11/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 N 2ND ST
LAUREL MD
20707-1866
US

IV. Provider business mailing address

108 FARMGATE LN
SILVER SPRING MD
20905-5759
US

V. Phone/Fax

Practice location:
  • Phone: 240-264-6846
  • Fax: 240-280-1918
Mailing address:
  • Phone: 703-675-8633
  • Fax: 240-280-1918

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. THERESIA FOMENKY DOH
Title or Position: ADMINISTRATOR/DON
Credential: RN
Phone: 703-675-8633