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General NPI Number Information
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NPI Number | 1982106928
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Entity Type | Organization
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Legal Business Name | JC HEALTH CENTER LLC
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Dates
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Enumeration Date | 03/06/2018
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Last Update Date | 03/06/2018
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Provider Practice Location Address
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Address Line | 8908 ELM AVE
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City | BOWIE
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State | MD
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Zip | 20720-3612
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Country | US
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Telephone | 301-385-8517
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Fax |
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Provider Business Mailing Address
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Address Line | 8908 ELM AVE
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City | BOWIE
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State | MD
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Zip | 20720-3612
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Country | US
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Telephone | 301-385-8517
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CHINMA NJOKU
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Credential | DNP
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Telephone | 301-464-1590
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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 | R172215
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License Number State | MD
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