| Express Home & Renal Healthcare, Llc. | |
|
10400 Connecticut Ave Ste 602 Kensington MD 20895-3909 | |
| (301) 825-5900 | |
| Not Available |
| Full Name | Express Home & Renal Healthcare, Llc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 10400 Connecticut Ave Ste 602, Kensington, Maryland |
| Authorized Official Name and Position | Solomon M Fon (OWNER) |
| Authorized Official Contact | 3017042667 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Express Home & Renal Healthcare, Llc. 10400 Connecticut Ave Ste 602 Kensington MD 20895-3909 Ph: (301) 825-5900 | Express Home & Renal Healthcare, Llc. 10400 Connecticut Ave Ste 602 Kensington MD 20895-3909 Ph: (301) 825-5900 |
| NPI Number | 1942991609 |
|---|---|
| Provider Enumeration Date | 05/15/2023 |
| Last Update Date | 05/15/2023 |
| Certification Date | 05/15/2023 |
| Medicare PECOS PAC ID | 9931553773 |
|---|---|
| Medicare Enrollment ID | O20230927001437 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942991609 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Janet Anywi Fon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275115420 PECOS PAC ID: 4981679537 Enrollment ID: I20230927001508 |
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