Provider Demographics
NPI:1164513974
Name:STATS MEDICAL SUPPLIES & EQUIPMENTS
Entity Type:Organization
Organization Name:STATS MEDICAL SUPPLIES & EQUIPMENTS
Other - Org Name:OLUSHOLA E.FASHINA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT-CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:OLUSHOLA
Authorized Official - Middle Name:E
Authorized Official - Last Name:FASHINA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-617-0066
Mailing Address - Street 1:8390 FROSTWOOD DR
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20724-3904
Mailing Address - Country:US
Mailing Address - Phone:301-617-0066
Mailing Address - Fax:
Practice Address - Street 1:8390 FROSTWOOD DR
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20724-3904
Practice Address - Country:US
Practice Address - Phone:301-617-0066
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR2412332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies