Provider Demographics
NPI:1417354184
Name:AU FAIT HEALTHCARE SERVICES INC
Entity Type:Organization
Organization Name:AU FAIT HEALTHCARE SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHARITY
Authorized Official - Middle Name:ANGEL
Authorized Official - Last Name:BARRETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-277-3004
Mailing Address - Street 1:PO BOX 1977
Mailing Address - Street 2:
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20604-1977
Mailing Address - Country:US
Mailing Address - Phone:202-277-3004
Mailing Address - Fax:888-557-2119
Practice Address - Street 1:7708 OLD ALEXANDRIA FERRY RD
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:MD
Practice Address - Zip Code:20735-1872
Practice Address - Country:US
Practice Address - Phone:202-277-3004
Practice Address - Fax:888-557-2119
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-24
Last Update Date:2014-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR207551363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Single Specialty