Provider Demographics
NPI:1841562675
Name:J3 HEALTHCARE SERVICES LLC
Entity Type:Organization
Organization Name:J3 HEALTHCARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ADEYEMI
Authorized Official - Middle Name:OLAWANDE
Authorized Official - Last Name:OJOMO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-613-8446
Mailing Address - Street 1:10686 SOURWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20603-5716
Mailing Address - Country:US
Mailing Address - Phone:301-613-8446
Mailing Address - Fax:301-632-6412
Practice Address - Street 1:100 M ST SE STE 600
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20003-3648
Practice Address - Country:US
Practice Address - Phone:301-613-8446
Practice Address - Fax:301-632-6412
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-09
Last Update Date:2015-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCNSA0317251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management