Provider Demographics
NPI:1215394556
Name:MOXIE G2 INC
Entity Type:Organization
Organization Name:MOXIE G2 INC
Other - Org Name:INTERIM HEALTHCARE OF ASHBURN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/COO
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOWELL
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN, MPH
Authorized Official - Phone:703-574-7317
Mailing Address - Street 1:44927 GEORGE WASHINGTON BLVD
Mailing Address - Street 2:SUITE 145
Mailing Address - City:ASHBURN
Mailing Address - State:VA
Mailing Address - Zip Code:20147-4295
Mailing Address - Country:US
Mailing Address - Phone:703-574-7317
Mailing Address - Fax:703-348-6213
Practice Address - Street 1:44927 GEORGE WASHINGTON BLVD
Practice Address - Street 2:SUITE 145
Practice Address - City:ASHBURN
Practice Address - State:VA
Practice Address - Zip Code:20147-4295
Practice Address - Country:US
Practice Address - Phone:703-574-7317
Practice Address - Fax:703-348-6213
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-18
Last Update Date:2017-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAHCO-181471251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health