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NPI Code Detail

MEDICARE: SHANTA MONTAGUE HHA

MEDICARE: SHANTA MONTAGUE HHA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1374U00000XHome Health Aide

General Provider Information

NPI Number : 1043586761
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHANTA MONTAGUE HHA
Provider Business Mailing Address
First Line : 3512 6TH ST SE
Second Line : APT 5
City : WASHINGTON
State : DC
Zip : 20032-3883
Country : US
Telephone Number : 202-421-0925
Fax Number :
Provider Business Practice Location Address
First Line : 1707 L ST NW
Second Line : SUITE 900
City : WASHINGTON
State : DC
Zip : 20036-4201
Country : US
Telephone Number : 202-829-1111
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/27/2012
Last Update Date : 03/27/2012

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Directions to “ SHANTA MONTAGUE HHA” Practice Location

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