Provider Demographics
NPI:1942507843
Name:FAWEMA NURSING CONTRACTOR, INC.
Entity Type:Organization
Organization Name:FAWEMA NURSING CONTRACTOR, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/DIRECTOR OF NURSING
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:NYAHALAY
Authorized Official - Last Name:KONNEH
Authorized Official - Suffix:
Authorized Official - Credentials:RN, CDDN
Authorized Official - Phone:301-220-0628
Mailing Address - Street 1:11460 CRONRIDGE DR STE 100
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-2264
Mailing Address - Country:US
Mailing Address - Phone:301-220-0628
Mailing Address - Fax:301-220-0629
Practice Address - Street 1:11460 CRONRIDGE DR STE 100
Practice Address - Street 2:
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-2264
Practice Address - Country:US
Practice Address - Phone:301-220-0628
Practice Address - Fax:301-220-0629
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FAWEMA ENTERPRISES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-02-12
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR2947251J00000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive Care