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General NPI Number Information
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NPI Number | 1609141019
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Entity Type | Organization
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Legal Business Name | ON THE GO MEDICAL STAFFING AND EDUCATION
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Dates
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Enumeration Date | 03/19/2012
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Last Update Date | 10/26/2020
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Provider Practice Location Address
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Address Line | 555 GROVE ST STE 100
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City | HERNDON
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State | VA
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Zip | 20170-4728
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Country | US
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Telephone | 571-707-9812
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Fax |
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Provider Business Mailing Address
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Address Line | 14579 GOLDEN OAK RD
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City | CENTREVILLE
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State | VA
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Zip | 20121-2261
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Country | US
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Telephone | 571-268-9366
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Fax |
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Authorized Official
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Title or Position | PARTNER/NURSE INSTRUCTOR
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Name | MISS MARY KATHLEEN GOODE
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Credential |
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Telephone | 571-268-9366
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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 | 0001197288
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | 0001197288
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License Number State | VA
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