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General NPI Number Information
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NPI Number | 1609564038
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Entity Type | Organization
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Legal Business Name | SC HOME HEALTH CARE SERVICE AGENCY
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Dates
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Enumeration Date | 04/25/2023
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Last Update Date | 04/28/2023
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Provider Practice Location Address
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Address Line | 2001 CONLEY CT
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City | SILVER SPRING
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State | MD
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Zip | 20904-6602
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Country | US
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Telephone | 202-679-6177
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Fax |
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Provider Business Mailing Address
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Address Line | 2001 CONLEY CT
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City | SILVER SPRING
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State | MD
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Zip | 20904-6602
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Country | US
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Telephone | 202-679-6177
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Fax |
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Authorized Official
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Title or Position | MANAGING DIRECTOR
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Name | SOLOMON HAILU
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Credential | PHARMD
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Telephone | 202-679-6177
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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