Provider Demographics
NPI:1629485966
Name:MASON HOME HEALTH NURSING AGENCY
Entity Type:Organization
Organization Name:MASON HOME HEALTH NURSING AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:UDOH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-529-5868
Mailing Address - Street 1:6706 SECOND MORNING CT
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21045-4950
Mailing Address - Country:US
Mailing Address - Phone:443-529-5868
Mailing Address - Fax:443-546-3674
Practice Address - Street 1:6706 SECOND MORNING CT
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-4950
Practice Address - Country:US
Practice Address - Phone:443-529-5868
Practice Address - Fax:443-546-3674
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-18
Last Update Date:2014-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health