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General NPI Number Information
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NPI Number | 1285867622
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Entity Type | Organization
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Legal Business Name | DJC HOME HEALTHCARE SERVICES
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Dates
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Enumeration Date | 09/02/2009
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Last Update Date | 09/02/2009
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Provider Practice Location Address
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Address Line | 1413 ANNAPOLIS RD SUITE 106
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City | ODENTON
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State | MD
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Zip | 21113-1216
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Country | US
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Telephone | 410-672-8906
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Fax | 410-672-8908
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Provider Business Mailing Address
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Address Line | P. O. BOX 307
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City | ODENTON
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State | MD
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Zip | 21113-1207
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Country | US
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Telephone | 410-672-8906
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Fax | 410-672-8908
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. BRENDA DENISE POPE
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Credential | MT(ASCP)
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Telephone | 410-672-8906
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | R2782
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License Number State | MD
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