Provider Demographics
NPI:1194832030
Name:BT HEALTHCARE SERVICES
Entity Type:Organization
Organization Name:BT HEALTHCARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:ABAYOMI
Authorized Official - Middle Name:
Authorized Official - Last Name:ILORI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-313-0963
Mailing Address - Street 1:4920 NIAGARA ROAD
Mailing Address - Street 2:
Mailing Address - City:COLLEGE ROAD
Mailing Address - State:MD
Mailing Address - Zip Code:29740
Mailing Address - Country:US
Mailing Address - Phone:301-313-0963
Mailing Address - Fax:301-313-0968
Practice Address - Street 1:4920 NIAGARA ROAD
Practice Address - Street 2:
Practice Address - City:COLLEGE ROAD
Practice Address - State:MD
Practice Address - Zip Code:29740
Practice Address - Country:US
Practice Address - Phone:301-313-0963
Practice Address - Fax:301-313-0968
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR682251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDR682Medicaid