Organization
E & A PEDIATRIC HOME HEALTH SERVICES
Active
Other names
Jefferson Nursing Svces
Organization subpart
No
Provider details
NPI number
Authorized official
ANASTASIE MBONO LICENSED NURSE (CEO/CFO)
(301) 806-2953
Entity
Organization
Contact information
Practice address
207 W. WASHINGTON STREET, CHARLES TOWN, WV 25414
(304) 724-2135
(304) 728-0839
Mailing address
658 CHAPELGATE DR, ODENTON, ODENTON, MD 21113
(301) 806-2953
(304) 728-0839
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
10/23/2020
Last updated
10/23/2020
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