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NPI Code Detail

MEDICARE: ALEX JEROME JOHNSON

MEDICARE:   ALEX JEROME JOHNSON
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
13747P1801XPersonal Care Attendant

General Provider Information

NPI Number : 1356839385
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALEX JEROME JOHNSON
Provider Business Mailing Address
First Line : 3690 HAYES ST NE APT T3
Second Line :
City : WASHINGTON
State : DC
Zip : 20019-7541
Country : US
Telephone Number : 202-361-9875
Fax Number :
Provider Business Practice Location Address
First Line : 3690 HAYES ST NE APT T3
Second Line :
City : WASHINGTON
State : DC
Zip : 20019-7541
Country : US
Telephone Number : 202-361-9875
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/25/2018
Last Update Date : 04/25/2018

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Directions to “ ALEX JEROME JOHNSON ” Practice Location

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