MEDICARE: FAMILY CARE HEALTH SERVICES LLC

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	251J00000X	Nursing Care Agency	R2394	MD

General Provider Information

NPI Number	:	1306013073
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAMILY CARE HEALTH SERVICES LLC

Provider Business Mailing Address
First Line	:	1416 CANADIAN GEESE COURT
Second Line	:
City	:	UPPER MARLBORO
State	:	MD
Zip	:	20774
Country	:	US
Telephone Number	:	301-537-6687
Fax Number	:	301-390-0377

Provider Business Practice Location Address
First Line	:	1416 CANADIEN GEESE CT
Second Line	:
City	:	UPPER MARLBORO
State	:	MD
Zip	:	20774-7062
Country	:	US
Telephone Number	:	301-537-6687
Fax Number	:	301-390-0377

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	JOY UGONNA ONYENEKWU
Credential	:
Telephone Number	:	301-537-6687

Provider Enumeration Date	:	05/13/2008
Last Update Date	:	05/13/2008

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