Organization
LIFELINE MEDICAL SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EZE J NWOJI MS (ADMINISTRATOR)
(301) 386-0000
Entity
Organization
Contact information
Practice address
1035 BLADENSBURG RD NE, WASHINGTON, DC 20002-2922
(301) 386-0000
(301) 386-0002
Mailing address
1035 BLADENSBURG RD NE, WASHINGTON, DC 20002-2922
(301) 792-6649
(301) 386-0002
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
404305700
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0206009741
VIRGINIA MEDICAID
—
05
—
037185800
—
DC
05
—
404305700
—
MD
Enumeration date
09/15/2006
Last updated
01/16/2024
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