Healthcare Provider Details
I. General information
NPI: 1437792405
Provider Name (Legal Business Name): AFRESH HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/23/2019
Last Update Date: 03/10/2025
Certification Date: 03/10/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6179 EXECUTIVE BLVD
ROCKVILLE MD
20852-3901
US
IV. Provider business mailing address
6179 EXECUTIVE BLVD
ROCKVILLE MD
20852-3901
US
V. Phone/Fax
- Phone: 240-994-3824
- Fax: 240-994-3636
- Phone: 240-994-3824
- Fax: 301-994-3636
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LP2300X |
| Taxonomy | Primary Care Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SYLVIE
TCHUINDJO
Title or Position: OWNER
Credential: NP
Phone: 240-994-3628