Provider Demographics
NPI:1235861311
Name:AKINBINU, OLUWAFEMI TOMMY (HOME HEALTH AIDE)
Entity Type:Individual
Prefix:MR
First Name:OLUWAFEMI
Middle Name:TOMMY
Last Name:AKINBINU
Suffix:
Gender:M
Credentials:HOME HEALTH AIDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:LIFELINE INC.
Mailing Address - Street 2:1615 KENILWORTH AVE, NE
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20019-2010
Mailing Address - Country:US
Mailing Address - Phone:202-588-8036
Mailing Address - Fax:
Practice Address - Street 1:LIFELINE INC.
Practice Address - Street 2:1615 KENILWORTH AVE, NE
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20019-2010
Practice Address - Country:US
Practice Address - Phone:202-588-8036
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-28
Last Update Date:2022-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HHA200001804374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide