Organization
PROCARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ISMAILA ODUBENA (MANAGING DIRECTOR)
(240) 606-4620
Entity
Organization
Contact information
Practice address
1705 SHAMROCK AVE, CAPITOL HEIGHTS, MD 20743-5302
(240) 606-4620
Mailing address
1705 SHAMROCK AVE, CAPITOL HEIGHTS, MD 20743-5302
(240) 606-4620
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
347C00000X
Private Vehicle
—
—
Other
Enumeration date
04/16/2014
Last updated
04/16/2014
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