Provider Demographics
NPI:1821221656
Name:PRINCE WEND MEDICAL AND HEALTH CARE CENTER
Entity Type:Organization
Organization Name:PRINCE WEND MEDICAL AND HEALTH CARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOSEPHINE
Authorized Official - Middle Name:CHINYERE
Authorized Official - Last Name:IGNIS
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:202-563-0300
Mailing Address - Street 1:4650 LIVINGSTON RD SE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20032-3136
Mailing Address - Country:US
Mailing Address - Phone:202-563-0300
Mailing Address - Fax:202-558-5537
Practice Address - Street 1:4650 LIVINGSTON RD SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20032-3136
Practice Address - Country:US
Practice Address - Phone:202-563-0300
Practice Address - Fax:202-558-5537
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-27
Last Update Date:2009-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center