Provider Demographics
NPI:1346892742
Name:BEULAH NURSING SERVICES LLC
Entity Type:Organization
Organization Name:BEULAH NURSING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ADEBISI
Authorized Official - Middle Name:
Authorized Official - Last Name:SHOWUNMI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-395-7874
Mailing Address - Street 1:3500 SUGAR MAPLE CT
Mailing Address - Street 2:
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20602-2625
Mailing Address - Country:US
Mailing Address - Phone:301-395-7874
Mailing Address - Fax:
Practice Address - Street 1:3500 SUGAR MAPLE CT
Practice Address - Street 2:
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20602-2625
Practice Address - Country:US
Practice Address - Phone:301-395-7874
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-15
Last Update Date:2019-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Multi-Specialty
No164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Multi-Specialty
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty
No376K00000XNursing Service Related ProvidersNurse's AideGroup - Multi-Specialty