Provider Demographics
NPI:1245742592
Name:BERHE, MEAZA (HOME HEALTH AID)
Entity Type:Individual
Prefix:MS
First Name:MEAZA
Middle Name:
Last Name:BERHE
Suffix:
Gender:F
Credentials:HOME HEALTH AID
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4809 GEORGIA AVE NW STE 113
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20011-4533
Mailing Address - Country:US
Mailing Address - Phone:202-291-0717
Mailing Address - Fax:202-808-2427
Practice Address - Street 1:4809 GEORGIA AVE NW STE 113
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20011-4533
Practice Address - Country:US
Practice Address - Phone:202-291-0717
Practice Address - Fax:202-808-2427
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-26
Last Update Date:2017-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA11937374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide