| 1530 Medical Services Inc | |
|
1160 Varnum St Ne Ste 218 Washington DC 20017-2106 | |
| (202) 269-6600 | |
| (202) 621-9564 |
| Full Name | 1530 Medical Services Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1160 Varnum St Ne Ste 218, Washington, District Of Columbia |
| Authorized Official Name and Position | Deborah Okonofua (CEO) |
| Authorized Official Contact | 2022696600 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| 1530 Medical Services Inc 1160 Varnum St Ne Ste 218 Washington DC 20017-2106 Ph: (202) 269-6600 | 1530 Medical Services Inc 1160 Varnum St Ne Ste 218 Washington DC 20017-2106 Ph: (202) 269-6600 |
| NPI Number | 1316518574 |
|---|---|
| Provider Enumeration Date | 07/08/2021 |
| Last Update Date | 04/23/2024 |
| Medicare PECOS PAC ID | 5496195257 |
|---|---|
| Medicare Enrollment ID | O20240428000052 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316518574 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Deborah E Okonofua |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023345873 PECOS PAC ID: 3274728696 Enrollment ID: I20101111000513 |
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