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General NPI Number Information
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NPI Number | 1821221656
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Entity Type | Organization
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Legal Business Name | PRINCE WEND MEDICAL AND HEALTH CARE CENTER
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Dates
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Enumeration Date | 08/27/2009
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Last Update Date | 08/27/2009
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Provider Practice Location Address
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Address Line | 4650 LIVINGSTON RD SE
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City | WASHINGTON
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State | DC
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Zip | 20032-3136
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Country | US
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Telephone | 202-563-0300
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Fax | 202-558-5537
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Provider Business Mailing Address
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Address Line | 4650 LIVINGSTON RD SE
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City | WASHINGTON
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State | DC
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Zip | 20032-3136
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Country | US
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Telephone | 202-563-0300
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Fax | 202-558-5537
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Authorized Official
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Title or Position | DIRECTOR
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Name | MRS. JOSEPHINE CHINYERE IGNIS
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Credential | FNP
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Telephone | 202-563-0300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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