Provider Demographics
NPI:1376852574
Name:STAT MEDICAL SERVICES INC.
Entity Type:Organization
Organization Name:STAT MEDICAL SERVICES INC.
Other - Org Name:DBA CHOICE PROFESSIONAL RESOURCES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BOLA
Authorized Official - Middle Name:
Authorized Official - Last Name:KUTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-870-3631
Mailing Address - Street 1:PO BOX 1396
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20773-1396
Mailing Address - Country:US
Mailing Address - Phone:301-870-3631
Mailing Address - Fax:
Practice Address - Street 1:401 CARROLL ST
Practice Address - Street 2:SUITE 104
Practice Address - City:LA PLATA
Practice Address - State:MD
Practice Address - Zip Code:20646-5986
Practice Address - Country:US
Practice Address - Phone:301-870-3631
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-05
Last Update Date:2010-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR1091251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care