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Organization

MEDICAID PROVIDERS, LLC.

Active
Other names
Medicaid Personal Providers, LLC.
Organization subpart
No

Provider details

NPI number
Authorized official
MISS LIDIYA F ABRHAM MED. ASIS/PHELOB. (DEPUTY ADMINISTRATOR)
(240) 533-2503
Entity
Organization

Contact information

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

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
PENDING
DC

Other

Enumeration date
06/15/2009
Last updated
06/15/2009
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