MEDICARE: ADVANTAGE AND PROTOCOL 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	174H00000X	Health Educator
2	172V00000X	Community Health Worker

General Provider Information

NPI Number	:	1588083794
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANTAGE AND PROTOCOL SERVICES, LLC

Provider Business Mailing Address
First Line	:	2832 6TH ST NE
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20017-1303
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2832 6TH ST NE
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20017-1303
Country	:	US
Telephone Number	:	202-391-1093
Fax Number	:

Authorized Official
Title or Position	:	OWNER/DIRECTOR
Name	:	KINIESHA ABRAHAM
Credential	:
Telephone Number	:	202-391-1093

Provider Enumeration Date	:	04/15/2014
Last Update Date	:	04/15/2014

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