MEDICARE: JD NURSING & MANAGEMENT SERVICES INC.

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
1	251E00000X	Home Health Agency	HHA11368	DC

General Provider Information

NPI Number	:	1073996740
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JD NURSING & MANAGEMENT SERVICES INC.

Provider Business Mailing Address
First Line	:	3823 64TH AVE
Second Line	:	#104
City	:	HYATTSVILLE
State	:	MD
Zip	:	20784-1830
Country	:	US
Telephone Number	:	240-413-1511
Fax Number	:

Provider Business Practice Location Address
First Line	:	3823 64TH AVE
Second Line	:	#104
City	:	HYATTSVILLE
State	:	MD
Zip	:	20784-1830
Country	:	US
Telephone Number	:	240-413-1511
Fax Number	:

Authorized Official
Title or Position	:	HHA
Name	:	LYCIA BEYONGE EKOLLE
Credential	:
Telephone Number	:	240-413-1511

Provider Enumeration Date	:	06/30/2015
Last Update Date	:	06/30/2015

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