Provider Demographics
NPI:1790478782
Name:AMERICAN GREATEST CARE LLC
Entity Type:Organization
Organization Name:AMERICAN GREATEST CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MBR
Authorized Official - Prefix:MR
Authorized Official - First Name:KOMI
Authorized Official - Middle Name:
Authorized Official - Last Name:KOUTCHE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-855-1516
Mailing Address - Street 1:300 NEW JERSEY AVE NW STE 900
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20001
Mailing Address - Country:US
Mailing Address - Phone:571-300-8000
Mailing Address - Fax:571-300-8001
Practice Address - Street 1:14087 RICHMOND HIGHWAY
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22191
Practice Address - Country:US
Practice Address - Phone:571-300-8000
Practice Address - Fax:571-300-8001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-26
Last Update Date:2023-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty