MEDICARE: ELROY JOHNSON II

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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1093587271
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELROY JOHNSON II

Provider Business Mailing Address
First Line	:	2105 WINDHAM PL
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20902-4313
Country	:	US
Telephone Number	:	202-378-6159
Fax Number	:

Provider Business Practice Location Address
First Line	:	2105 WINDHAM PL
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20902-4313
Country	:	US
Telephone Number	:	202-378-6159
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/23/2023
Last Update Date	:	10/23/2023

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Directions to “ ELROY JOHNSON II ” Practice Location

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