Organization
WAVECARE HEALTH SERVICES LLC
Active
Parent organization
WAVECARE HEALTHCARE SERVICE LLC
Other names
WaveCare HealthCare Service LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
WAVECARE HEALTHCARE SERVICE LLC
Authorized official
MRS. WAVENEY A BLACKMAN (CEO/PRESIDENT)
(301) 237-1141
Entity
Organization
Contact information
Practice address
8725 GREENBELT RD, SUITE 203, GREENBELT, MD 20770-2475
(202) 388-9555
(202) 388-9558
Mailing address
11900 LISBOROUGH RD, BOWIE, MD 20720-3405
(301) 237-1141
(202) 388-9555
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
R3786
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
039537200
—
DC
05
—
421615600
—
MD
Enumeration date
01/29/2016
Last updated
05/10/2016
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