1528378528 NPI number — HIGHLY BLESSED HEALTHCARE SERVICES

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528378528 NPI number — HIGHLY BLESSED HEALTHCARE SERVICES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HIGHLY BLESSED HEALTHCARE SERVICES
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:
1528378528
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/09/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9251 LOTTSFORD RD APT 3D
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LARGO
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20774-3769
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
240-988-2626
Provider Business Mailing Address Fax Number:
301-350-3429

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9251 LOTTSFORD RD APT 3D
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LARGO
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20774-3769
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
240-988-2626
Provider Business Practice Location Address Fax Number:
301-350-3429
Provider Enumeration Date:
10/09/2010

Additional Information

Authorized Official

Authorized Official Last Name:
AGBODO
Authorized Official First Name:
AKINJIDE
Authorized Official Middle Name:
DAVID
Authorized Official Title or Position:
PHARMACIST
Authorized Official Telephone Number:
240-988-2626

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  R2942P , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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