Provider Demographics
NPI:1821755745
Name:JUMOTEK INCORPORATED
Entity Type:Organization
Organization Name:JUMOTEK INCORPORATED
Other - Org Name:JUMOTEK HEALTHCARE SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:CHINAEREZI
Authorized Official - Last Name:UGBAJA
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:240-476-2696
Mailing Address - Street 1:4203 58TH AVE APT 5
Mailing Address - Street 2:
Mailing Address - City:BLADENSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20710-1911
Mailing Address - Country:US
Mailing Address - Phone:301-675-9271
Mailing Address - Fax:240-900-3677
Practice Address - Street 1:4203 58TH AVE APT 5
Practice Address - Street 2:
Practice Address - City:BLADENSBURG
Practice Address - State:MD
Practice Address - Zip Code:20710-1911
Practice Address - Country:US
Practice Address - Phone:301-675-9271
Practice Address - Fax:240-900-3677
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-27
Last Update Date:2023-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health