Healthcare Provider Details

I. General information

NPI: 1962983429
Provider Name (Legal Business Name): MY 3 GIBBYS CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/23/2018
Last Update Date: 06/12/2024
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5840 HUBBARD DR
NORTH BETHESDA MD
20852-4820
US

IV. Provider business mailing address

5840 HUBBARD DR
NORTH BETHESDA MD
20852-4820
US

V. Phone/Fax

Practice location:
  • Phone: 301-340-0100
  • Fax: 301-340-0105
Mailing address:
  • Phone: 301-340-0100
  • Fax: 301-340-0105

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License NumberR3000
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License NumberR3000
License Number StateMD

VIII. Authorized Official

Name: MR. DAVID GIBSON
Title or Position: PRESIDENT/OWNER
Credential:
Phone: 301-340-0100