MEDICARE: MWDLINE HEALTH SERVICES

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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1699279356
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MWDLINE HEALTH SERVICES

Provider Business Mailing Address
First Line	:	11908 MAHER DR
Second Line	:
City	:	FORT WASHINGTON
State	:	MD
Zip	:	20744-5938
Country	:	US
Telephone Number	:	301-235-3026
Fax Number	:

Provider Business Practice Location Address
First Line	:	11908 MAHER DR
Second Line	:
City	:	FORT WASHINGTON
State	:	MD
Zip	:	20744-5938
Country	:	US
Telephone Number	:	301-235-3026
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	ALFRED WILLIAM CANNON JR.
Credential	:
Telephone Number	:	301-235-3026

Provider Enumeration Date	:	03/19/2018
Last Update Date	:	06/16/2018

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Directions to “MWDLINE HEALTH SERVICES ” Practice Location

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