Provider Demographics
NPI:1588389647
Name:ASIMWE, GARVIN
Entity type:Individual
Prefix:
First Name:GARVIN
Middle Name:
Last Name:ASIMWE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:255 NORTH RD UNIT 109
Mailing Address - Street 2:
Mailing Address - City:CHELMSFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01824-1428
Mailing Address - Country:US
Mailing Address - Phone:857-800-1872
Mailing Address - Fax:
Practice Address - Street 1:24 STEDMAN ST
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01851-2703
Practice Address - Country:US
Practice Address - Phone:857-800-1872
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-11
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide