Provider Demographics
NPI:1174218382
Name:CHIMANGHA, HERBERT
Entity type:Individual
Prefix:
First Name:HERBERT
Middle Name:
Last Name:CHIMANGHA
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 1:9009 SPRING AVE
Mailing Address - Street 2:
Mailing Address - City:LANHAM SEABROOK
Mailing Address - State:MD
Mailing Address - Zip Code:20706-2813
Mailing Address - Country:US
Mailing Address - Phone:240-713-0862
Mailing Address - Fax:
Practice Address - Street 1:9009 SPRING AVE
Practice Address - Street 2:
Practice Address - City:SEABROOK
Practice Address - State:MD
Practice Address - Zip Code:20706-2813
Practice Address - Country:US
Practice Address - Phone:240-713-0862
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-05
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC374U00000X
374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide