=====================================================
General NPI Number Information
=====================================================
NPI Number | 1437412798
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MILESTONE MEDICAL SERVICES INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/21/2012
-----------------------------------------------------
Last Update Date | 06/28/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7676 NEW HAMPSHIRE AVE SUITE 420
-----------------------------------------------------
City | TAKOMA PARK
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 20912-7512
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 301-408-1885
-----------------------------------------------------
Fax | 301-408-1828
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7676 NEW HAMPSHIRE AVE SUITE 420
-----------------------------------------------------
City | TAKOMA PARK
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 20912-7512
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 301-408-1885
-----------------------------------------------------
Fax | 301-408-1828
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MEDICAL DIRECTOR
-----------------------------------------------------
Name | DR. FELICIA U BASSEY-AKAMUNE
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 301-408-1885
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 261Q00000X
-----------------------------------------------------
Taxonomy Name | Clinic/Center
-----------------------------------------------------
License Number | D0051667
-----------------------------------------------------
License Number State | MD
-----------------------------------------------------