Healthcare Provider Details

I. General information

NPI: 1972887669
Provider Name (Legal Business Name): ESTEEMCARE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2011
Last Update Date: 09/29/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3301 WOODBURN RD SUITE 304B
ANNANDALE VA
22003-1229
US

IV. Provider business mailing address

3223 SUNSET BLVD SUITE 104
WEST COLUMBIA SC
29169-3200
US

V. Phone/Fax

Practice location:
  • Phone: 866-936-9376
  • Fax:
Mailing address:
  • Phone: 803-936-9376
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: MR. MADHU M MATHEW
Title or Position: PRESIDENT/CEO
Credential:
Phone: 770-990-7042