Provider Demographics
NPI:1033750203
Name:MEDSTAR HOMECARE SERVICES LLC
Entity Type:Organization
Organization Name:MEDSTAR HOMECARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LIDA
Authorized Official - Middle Name:
Authorized Official - Last Name:SULAYMANHEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-870-6969
Mailing Address - Street 1:9729 LAKEPOINTE DR
Mailing Address - Street 2:
Mailing Address - City:BURKE
Mailing Address - State:VA
Mailing Address - Zip Code:22015-1881
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9729 LAKEPOINTE DR
Practice Address - Street 2:
Practice Address - City:BURKE
Practice Address - State:VA
Practice Address - Zip Code:22015-1881
Practice Address - Country:US
Practice Address - Phone:703-870-6969
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-30
Last Update Date:2019-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care