Organization
ROSEFIDELIS OMNICARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SCHOLASTICA NWABUEZE (CEO)
(240) 413-0181
Entity
Organization
Contact information
Practice address
3815 ALTA VISTA DRIVE, BOWIE, MD 20721
(240) 413-0181
(301) 577-1436
Mailing address
3815 ALTA VISTA DRIVE, BOWIE, MD 20721
(240) 413-0181
(301) 577-1436
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
—
—
163WH0200X
Home Health Registered Nurse
Primary
—
—
164W00000X
Licensed Practical Nurse
—
—
Other
Enumeration date
09/19/2017
Last updated
09/19/2017
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