MEDICARE: ELSIE I FORCHU

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	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1891489043
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELSIE I FORCHU

Provider Business Mailing Address
First Line	:	1615 RHODE ISLAND AVE NE
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20018-1802
Country	:	US
Telephone Number	:	202-832-1698
Fax Number	:	202-832-0980

Provider Business Practice Location Address
First Line	:	4811 ATLAS CEDAR WAY
Second Line	:
City	:	ABERDEEN
State	:	MD
Zip	:	21001-5602
Country	:	US
Telephone Number	:	667-231-8256
Fax Number	:

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

Provider Enumeration Date	:	06/08/2023
Last Update Date	:	06/08/2023

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