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General NPI Number Information
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NPI Number | 1821755968
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Entity Type | Organization
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Legal Business Name | EXPRESS HOME & RENAL HEALTHCARE, LLC.
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Dates
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Enumeration Date | 11/23/2021
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Last Update Date | 11/23/2021
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Provider Practice Location Address
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Address Line | 10400 CONNECTICUT AVE STE 602
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City | KENSINGTON
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State | MD
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Zip | 20895-3909
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Country | US
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Telephone | 301-704-2667
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Fax | 301-649-2109
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Provider Business Mailing Address
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Address Line | 10400 CONNECTICUT AVE STE 602
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City | KENSINGTON
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State | MD
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Zip | 20895-3909
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Country | US
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Telephone | 301-704-2667
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Fax | 301-649-2109
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Authorized Official
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Title or Position | CEO/ADMINISTRATOR
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Name | MR. SOLOMON M FON
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Credential | CPA
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Telephone | 301-704-2667
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251F00000X
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Taxonomy Name | Home Infusion Agency
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License Number |
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License Number State |
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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 |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 385HR2065X
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Taxonomy Name | Child Physical Disabilities Respite Care
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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