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General NPI Number Information
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NPI Number | 1336453208
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Entity Type | Organization
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Legal Business Name | MA-LOWE HOME CARE AGENCY MANASSAS, INC
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Dates
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Enumeration Date | 08/03/2010
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Last Update Date | 08/03/2010
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Provider Practice Location Address
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Address Line | 8811 SUDLEY RD SUITE 209
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City | MANASSAS
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State | VA
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Zip | 20110-4750
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Country | US
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Telephone | 703-392-4240
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Fax | 703-392-4243
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Provider Business Mailing Address
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Address Line | 8811 SUDLEY RD SUITE 209
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City | MANASSAS
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State | VA
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Zip | 20110-4750
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Country | US
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Telephone | 703-392-4240
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Fax | 703-392-4243
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Authorized Official
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Title or Position | PRESIDENT/ADMINISTRATOR
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Name | MRS. MARIAMA LOWE
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Credential | REGISTERED NURSE
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Telephone | 703-392-4240
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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 | HCO-11550
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License Number State | VA
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