Organization · NPI-2

St. Augustin Healthcare Services L.L.C

Registered Nurse, General Practice · Upper Marlboro, MD

NPI number1831902915
StatusActive
Last updated in NPPESJan 31, 2025

Details

NPI
1831902915
Entity type
Organization (NPI-2)
Legal business name
St. Augustin Healthcare Services L.L.C
Organization subpart
No
Enumeration date
Jan 31, 2025
Certification date
Jan 31, 2025
Last updated
Jan 31, 2025

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
163WG0000X Registered Nurse, General Practice––Yes

Other names

  • St. Augustin Healthcare Services L.L.C (Former Legal Business Name)

Practice location

9105 Jousting Ln
Upper Marlboro, MD 20772-4388

Phone 240-872-6598

Mailing address

3301 Richmond Hwy
Alexandria, VA 22305-3044

Phone 240-872-6598

Authorized official

Basil Teghen Ndum
Manager
2408726598

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