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NPI Code Detail

MEDICARE: CHANCELINE KOMETA HHA

MEDICARE: CHANCELINE KOMETA HHA
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
1374U00000XHome Health Aide

General Provider Information

NPI Number : 1518388750
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHANCELINE KOMETA HHA
Provider Business Mailing Address
First Line : 9007 GOODLUCKROAD
Second Line :
City : LAHAM
State : MD
Zip : 20607
Country : US
Telephone Number : 240-534-0049
Fax Number : 202-545-0934
Provider Business Practice Location Address
First Line : 9007 GOOD LUCK RD
Second Line :
City : LANHAM
State : MD
Zip : 20706-3422
Country : US
Telephone Number : 240-543-0049
Fax Number : 202-545-0934
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/13/2013
Last Update Date : 12/13/2013

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Directions to “ CHANCELINE KOMETA HHA” Practice Location

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