Provider Demographics
NPI:1467797639
Name:TREATMENT 1
Entity Type:Organization
Organization Name:TREATMENT 1
Other - Org Name:LADYBUG/ YES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:HISTOLOGY ASSITANT/ SURVEY ATTENDAN
Authorized Official - Prefix:MS
Authorized Official - First Name:TONDALAYO
Authorized Official - Middle Name:
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:CERTIFICATION
Authorized Official - Phone:202-390-8043
Mailing Address - Street 1:2431 25TH ST SE APT 1
Mailing Address - Street 2:
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:20002-0000
Mailing Address - Country:US
Mailing Address - Phone:202-390-8043
Mailing Address - Fax:
Practice Address - Street 1:2431 25TH ST SE APT 1
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020-3467
Practice Address - Country:US
Practice Address - Phone:202-390-8043
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:9995.003/FTA-2012-006-TPM-VTCL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-11-29
Last Update Date:2012-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCFTA-2012-006-TPM-VTC332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies