MEDICARE: JOKE SOWOLE

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	374U00000X	Home Health Aide
2	171M00000X	Case Manager/Care Coordinator		DC

General Provider Information

NPI Number	:	1811256845
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOKE SOWOLE

Provider Business Mailing Address
First Line	:	3831 PENNSYLVANIA AVE SE
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20020-1309
Country	:	US
Telephone Number	:	202-853-4879
Fax Number	:	202-575-1001

Provider Business Practice Location Address
First Line	:	3831 PENNSYLVANIA AVE SE
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20020-1309
Country	:	US
Telephone Number	:	202-853-4879
Fax Number	:	202-575-1001

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/11/2012
Last Update Date	:	07/26/2024

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Directions to “ JOKE SOWOLE ” Practice Location

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