Provider Demographics
NPI:1134525066
Name:ABSOLUTE CARE THERAPY & DME SERVICES
Entity type:Organization
Organization Name:ABSOLUTE CARE THERAPY & DME SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO/ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:AUGUSTINA
Authorized Official - Middle Name:OLA
Authorized Official - Last Name:ENWEZE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-254-1180
Mailing Address - Street 1:11002 VEIRS MILL RD
Mailing Address - Street 2:SUITE 700
Mailing Address - City:WHEATON
Mailing Address - State:MD
Mailing Address - Zip Code:20902-2574
Mailing Address - Country:US
Mailing Address - Phone:240-491-4101
Mailing Address - Fax:240-491-4103
Practice Address - Street 1:11002 VEIRS MILL RD
Practice Address - Street 2:SUITE 700
Practice Address - City:WHEATON
Practice Address - State:MD
Practice Address - Zip Code:20902-2574
Practice Address - Country:US
Practice Address - Phone:240-491-4101
Practice Address - Fax:240-491-4103
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ABSOLUTE CARE NURSING
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-11-04
Last Update Date:2014-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR3498251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD1811293277Medicaid