NPIMap

Organization Active NPI

Gosheni LLC

  • Health Service Clinic/Center
  • Upper Marlboro, MD
National Provider Identifier
1679024913
Registry record updated Oct 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
License
HCSA9912127 Issued in MD
Legal business name
GOSHENI LLC
Practice address
605 Avis Dr
Upper Marlboro, MD 20774-2283
Phone
(301) 232-7685
Fax
(301) 324-0897
NPI assigned
Oct 21, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2016

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

Authorized official

Name
Mr. Samson OloweNPI 1902272784
Title
President
Phone
(301) 221-7553

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X HCSA9912127 MD Primary

Addresses

Primary practice location

605 Avis Dr
Upper Marlboro, MD 20774-2283

Mailing address

605 Avis Dr
Upper Marlboro, MD 20774-2283
Phone (301) 232-7685

Other names 1

  • GOSHENI HEALTHCARE SERVICES Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1477008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477008000000",
    "number": "1679024913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 AVIS DR",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207742283",
            "telephone_number": "301-232-7685",
            "fax_number": "301-324-0897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 AVIS DR",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207742283",
            "telephone_number": "301-232-7685",
            "fax_number": "301-324-0897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOSHENI LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-21",
        "last_updated": "2016-10-21",
        "status": "A",
        "authorized_official_last_name": "OLOWE",
        "authorized_official_first_name": "SAMSON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "301-221-7553",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "MD",
            "license": "HCSA9912127",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GOSHENI HEALTHCARE SERVICES",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Upper Marlboro, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2016; 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.