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NPI Code Detail

MEDICARE: HENRY A EBESOH

MEDICARE:   HENRY A EBESOH
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 : 1588929400
Entity Type Code : Individual
Provider Name (Legal Business Name) : HENRY A EBESOH
Provider Business Mailing Address
First Line : 6558 PRINCESS GARDEN PKWY
Second Line :
City : LANHAM
State : MD
Zip : 20706-3533
Country : US
Telephone Number : 240-280-5800
Fax Number :
Provider Business Practice Location Address
First Line : 6558 PRINCESS GARDEN PKWY
Second Line :
City : LANHAM
State : MD
Zip : 20706-3533
Country : US
Telephone Number : 240-280-5800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/06/2012
Last Update Date : 07/06/2012

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Directions to “ HENRY A EBESOH ” Practice Location

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