Healthcare Provider Details

I. General information

NPI: 1336585553
Provider Name (Legal Business Name): 1ST CHOICE HOME HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2013
Last Update Date: 05/14/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1414 CANADIEN GEESE CT
UPPER MARLBORO MD
20774-7062
US

IV. Provider business mailing address

1414 CANADIEN GEESE CT
UPPER MARLBORO MD
20774-7062
US

V. Phone/Fax

Practice location:
  • Phone: 301-741-4211
  • Fax:
Mailing address:
  • Phone: 301-741-4211
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. FATMATA BINTA BAH
Title or Position: ADMINISTRATOR
Credential: RN, BSN
Phone: 301-741-4211