Provider Demographics
NPI:1003412594
Name:GARVIN, HENRY JR
Entity Type:Individual
Prefix:
First Name:HENRY
Middle Name:
Last Name:GARVIN
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5322 JAMES PL NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20019-7023
Mailing Address - Country:US
Mailing Address - Phone:202-487-3994
Mailing Address - Fax:
Practice Address - Street 1:5322 JAMES PL NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20019-7023
Practice Address - Country:US
Practice Address - Phone:202-487-3994
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-09
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker