Provider Demographics
NPI:1104308626
Name:GOWEM INC.
Entity type:Organization
Organization Name:GOWEM INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MCMAURICE
Authorized Official - Middle Name:CHINONSO
Authorized Official - Last Name:NDUBUEZE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:757-300-7980
Mailing Address - Street 1:5215 COLLEY AVE STE 112
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23508-2166
Mailing Address - Country:US
Mailing Address - Phone:757-321-0064
Mailing Address - Fax:757-257-3332
Practice Address - Street 1:5215 COLLEY AVE STE 112
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23508-2166
Practice Address - Country:US
Practice Address - Phone:757-321-0064
Practice Address - Fax:757-257-3332
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-31
Last Update Date:2018-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251F00000X, 251J00000X, 253Z00000X, 385H00000X
VAHCO-191887251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251F00000XAgenciesHome Infusion
No251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive Care
No385H00000XRespite Care FacilityRespite Care