1235443250 NPI number — SAINT THERESA NURSELINK INC

Table of content: (NPI 1235443250)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1235443250 NPI number — SAINT THERESA NURSELINK INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SAINT THERESA NURSELINK INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1235443250
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/26/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7207 HANOVER PARKWAY
Provider Second Line Business Mailing Address:
STE C & D
Provider Business Mailing Address City Name:
GREENBELT
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20770-2015
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-459-0199
Provider Business Mailing Address Fax Number:
301-459-3039

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7207 HANOVER PKWAY
Provider Second Line Business Practice Location Address:
STE C & D
Provider Business Practice Location Address City Name:
GREENBELT
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20770-2015
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-464-8189
Provider Business Practice Location Address Fax Number:
301-860-0256
Provider Enumeration Date:
08/02/2010

Additional Information

Authorized Official

Authorized Official Last Name:
OLUWATOYIN
Authorized Official First Name:
OLUWATOYIN
Authorized Official Middle Name:
ABOSEDE
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
301-464-8189

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  R2651 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 251E00000X , with the licence number: 0911004 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 4203542 00 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4200471 00 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 9094008 00 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 9094016 00 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".




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