MEDICARE: ALPHONSIE POUMENI

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	3747P1801X	Personal Care Attendant	HHA200003151	DC
2	374U00000X	Home Health Aide	20003151	DC

General Provider Information

NPI Number	:	1386416899
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALPHONSIE POUMENI

Provider Business Mailing Address
First Line	:	11205 LANETTE LN
Second Line	:
City	:	GLENN DALE
State	:	MD
Zip	:	20769-9225
Country	:	US
Telephone Number	:	240-302-7368
Fax Number	:

Provider Business Practice Location Address
First Line	:	11205 LANETTE LN
Second Line	:
City	:	GLENN DALE
State	:	MD
Zip	:	20769-9225
Country	:	US
Telephone Number	:	240-302-7368
Fax Number	:

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

Provider Enumeration Date	:	10/27/2023
Last Update Date	:	02/06/2026

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Directions to “ ALPHONSIE POUMENI ” Practice Location

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