MEDICARE: NYAME NTI NATURAL HEALTH SOLUTIONS, 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	261Q00000X	Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1639467939
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NYAME NTI NATURAL HEALTH SOLUTIONS, LLC

Provider Business Mailing Address
First Line	:	3424 N ST SE
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20019-2958
Country	:	US
Telephone Number	:	202-491-5687
Fax Number	:	202-478-1677

Provider Business Practice Location Address
First Line	:	3424 N ST SE
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20019-2958
Country	:	US
Telephone Number	:	202-491-5687
Fax Number	:	202-478-1677

Authorized Official
Title or Position	:	DIRECTOR
Name	:	DR. AMA ASANTEWAA TYUS
Credential	:	M.D.
Telephone Number	:	202-491-5687

Provider Enumeration Date	:	07/20/2011
Last Update Date	:	08/01/2017

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