Provider Homecare, LLC

Primary specialty

Home Health AideTaxonomy code 374U00000X

Legal business name

PROVIDER HOMECARE, LLC

Practice address

11220 Evans TRL Apt 203
Beltsville, MD 20705-3913

Phone

(301) 938-5986

Fax

(240) 542-4398

NPI assigned

Dec 20, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Elisabeth Babatunde

Title

Ceo

Phone

(301) 938-5986

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1545264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1545264000000",
    "number": "1316419997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10482 BALTIMORE AVE STE 260",
            "city": "BELTSVILLE",
            "state": "MD",
            "postal_code": "207052321",
            "telephone_number": "301-938-5986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11220 EVANS TRL APT 203",
            "city": "BELTSVILLE",
            "state": "MD",
            "postal_code": "207053913",
            "telephone_number": "301-938-5986",
            "fax_number": "240-542-4398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDER HOMECARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-20",
        "last_updated": "2018-12-20",
        "status": "A",
        "authorized_official_last_name": "BABATUNDE",
        "authorized_official_first_name": "ELISABETH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "301-938-5986"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Home Health Aide",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hadden Probst
• Alyssa Proctor
• Professional Services of Holy Cross
• Progressive Quality Nursings Care Services, Inc.
• Michaela Proud
• Mushiya Monique Pulanco-Clement
• Matthew Kalala Pulanco
• Kerry Purdy
• Purple Heart Health and Nursing Agency
• Purple Heart Health and Nursing Agency

• Home Health Aide in Beltsville, MD
• Providers in Beltsville, MD by specialty
• Home Health Aide in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.