Individual ProviderTheophilus TakoRegistered NurseNursing Service ProvidersPractice Address7600 Georgia Ave NW, Washington, DC 20012-1616(202) 723-3060PECOS EnrollmentBased on the most recent information from CMS, provider Theophilus Tako does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 4 days ago.Profile DetailsProvider ID1003213935Provider TypeIndividualFull NameTako, TheophilusGenderMaleSole ProprietorYesEnumeration Date11/20/2014Last Updated11/20/2014Contact InformationPractice LocationPractice Address7600 Georgia Ave NW, Washington, DC 20012-1616Phone(202) 723-3060Fax(202) 723-3065Mailing LocationMailing Address7600 Georgia Ave NW, Washington, DC 20012-1616Phone(202) 723-3060Fax(202) 723-3065Provider TaxonomiesCodeDescriptionLicenseCode163W00000XPrimaryDescriptionRegistered NurseNursing Service ProvidersLicenseRN1029696District of Columbia