Provider Demographics
NPI:1760630479
Name:CAMUSUKGROUP INC
Entity Type:Organization
Organization Name:CAMUSUKGROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:FOMUM
Authorized Official - Last Name:MUGRI
Authorized Official - Suffix:II
Authorized Official - Credentials:
Authorized Official - Phone:301-320-3086
Mailing Address - Street 1:6300 MARJORY LN
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20817-5804
Mailing Address - Country:US
Mailing Address - Phone:301-320-3086
Mailing Address - Fax:301-320-0000
Practice Address - Street 1:6300 MARJORY LN
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20817-5804
Practice Address - Country:US
Practice Address - Phone:301-320-3086
Practice Address - Fax:301-320-0000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-05
Last Update Date:2008-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR2633P251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD21324OtherRSA