# E & A PEDIATRIC HOME HEALTH SERVICES

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Jefferson Nursing Svces
- **Organization subpart:** No

## Provider details

- **NPI number:** 1720687478
- **Authorized official:** ANASTASIE MBONO LICENSED NURSE (CEO/CFO)
- **Authorized official phone:** (301) 806-2953

## Contact information

- **Practice address:** 207 W. WASHINGTON STREET, CHARLES TOWN, WV 25414
- **Practice address phone:** (304) 724-2135
- **Practice address fax:** (304) 728-0839
- **Mailing address:** 658 CHAPELGATE DR, ODENTON, ODENTON, MD 21113
- **Mailing address phone:** (301) 806-2953
- **Mailing address fax:** (304) 728-0839

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 10/23/2020
- **Last updated:** 10/23/2020