Healthcare Provider Details

I. General information

NPI: 1558942771
Provider Name (Legal Business Name): EMILE WORLEY
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2021
Last Update Date: 12/01/2023
Certification Date: 12/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6813 RIVERDALE RD
RIVERDALE MD
20737-1800
US

IV. Provider business mailing address

6813 RIVERDALE RD
RIVERDALE MD
20737-1800
US

V. Phone/Fax

Practice location:
  • Phone: 720-486-1718
  • Fax: 410-946-2010
Mailing address:
  • Phone: 720-486-1718
  • Fax: 410-946-2010

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberHHA200002473
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: