# MEDICAID PROVIDERS, LLC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Medicaid Personal Providers, LLC.
- **Organization subpart:** No

## Provider details

- **NPI number:** 1073740379
- **Authorized official:** MISS LIDIYA F ABRHAM MED. ASIS/PHELOB. (DEPUTY ADMINISTRATOR)
- **Authorized official phone:** (240) 533-2503

## Contact information

- **Practice address:** 1875 EYE ST NW, SUITE 500, WASHINGTON, DC 20006-5409
- **Practice address phone:** (240) 533-2805
- **Practice address fax:** (301) 495-6332
- **Mailing address:** 1875 EYE ST NW, SUITE 500, WASHINGTON, DC 20006-5409
- **Mailing address phone:** (240) 533-2805
- **Mailing address fax:** (301) 495-6332

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | PENDING | DC | Yes |

## Other

- **Enumeration date:** 06/15/2009
- **Last updated:** 06/15/2009