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General NPI Number Information
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NPI Number | 1538583653
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Entity Type | Organization
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Legal Business Name | FERNELLAS QUALITY CARE
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Dates
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Enumeration Date | 02/10/2014
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Last Update Date | 02/10/2014
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Provider Practice Location Address
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Address Line | 2300 24TH ROAD SOUTH #624
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City | ARLINGTON
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State | VA
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Zip | 22206
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Country | US
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Telephone | 571-435-5032
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Fax |
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Provider Business Mailing Address
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Address Line | 2300 24TH ROAD SOUTH #624
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City | ARLINGTON
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State | VA
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Zip | 22206
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CARE COORDINATION CONSULTANT
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Name | BERNADETTE BENTA
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Credential | RN, MSHCA
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Telephone | 571-435-5032
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133N00000X
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Taxonomy Name | Nutritionist
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License Number | R146754
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | R146754
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number | R146754
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License Number State | MD
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Taxonomy #4
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Taxonomy Code | 261QA0005X
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Taxonomy Name | Ambulatory Family Planning Facility
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License Number | R146754
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License Number State |
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Taxonomy #5
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Taxonomy Code | 281P00000X
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Taxonomy Name | Chronic Disease Hospital
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License Number | R146754
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License Number State | MD
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Taxonomy #6
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Taxonomy Code | 281PC2000X
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Taxonomy Name | Children's Chronic Disease Hospital
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License Number | R146754
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License Number State | MD
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Taxonomy #7
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Taxonomy Code | 282NC2000X
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Taxonomy Name | Children's Hospital
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License Number | R146754
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License Number State | MD
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Taxonomy #8
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | R146754
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License Number State | MD
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Taxonomy #9
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Taxonomy Code | 293D00000X
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Taxonomy Name | Physiological Laboratory
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License Number | R146754
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License Number State | MD
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Taxonomy #10
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Taxonomy Code | 302F00000X
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Taxonomy Name | Exclusive Provider Organization
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License Number | R146754
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License Number State | MD
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Taxonomy #11
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Taxonomy Code | 302F00000X
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Taxonomy Name | Exclusive Provider Organization
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License Number | R146754
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License Number State |
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Taxonomy #12
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number | R146754
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License Number State | MD
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Taxonomy #13
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Taxonomy Code | 305R00000X
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Taxonomy Name | Preferred Provider Organization
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License Number | R146754
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License Number State | MD
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Taxonomy #14
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Taxonomy Code | 305S00000X
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Taxonomy Name | Point of Service
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License Number | R146754
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License Number State | MD
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Taxonomy #15
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | R146754
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License Number State |
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