Provider Demographics
NPI:1417518028
Name:OAC ENTERPRISES LLC
Entity Type:Organization
Organization Name:OAC ENTERPRISES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ADEDEJI
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:OLAGUNJU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-505-5158
Mailing Address - Street 1:415 70TH ST
Mailing Address - Street 2:
Mailing Address - City:CAPITOL HEIGHTS
Mailing Address - State:MD
Mailing Address - Zip Code:20743-2239
Mailing Address - Country:US
Mailing Address - Phone:240-505-5158
Mailing Address - Fax:
Practice Address - Street 1:415 70TH ST
Practice Address - Street 2:
Practice Address - City:CAPITOL HEIGHTS
Practice Address - State:MD
Practice Address - Zip Code:20743-2239
Practice Address - Country:US
Practice Address - Phone:240-505-5158
Practice Address - Fax:240-200-8712
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-25
Last Update Date:2019-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD1568931905Medicaid