Provider Demographics
NPI:1871937284
Name:DISTRICT OF COLUMBIA
Entity type:Organization
Organization Name:DISTRICT OF COLUMBIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HHA
Authorized Official - Prefix:
Authorized Official - First Name:BABATUNDE
Authorized Official - Middle Name:T
Authorized Official - Last Name:TAJUDEEN
Authorized Official - Suffix:I
Authorized Official - Credentials:
Authorized Official - Phone:301-640-1490
Mailing Address - Street 1:919 SHARMA ST
Mailing Address - Street 2:919 SHARMA ST
Mailing Address - City:CAPITOL HEIGHTS
Mailing Address - State:MD
Mailing Address - Zip Code:20743-1700
Mailing Address - Country:US
Mailing Address - Phone:240-264-0267
Mailing Address - Fax:
Practice Address - Street 1:919 SHARMA ST
Practice Address - Street 2:
Practice Address - City:CAPITOL HT MARYLAND
Practice Address - State:MD
Practice Address - Zip Code:20743
Practice Address - Country:US
Practice Address - Phone:240-264-0267
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-29
Last Update Date:2013-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD212279378251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health