Provider Demographics
NPI:1477689032
Name:BOWLEM GROUP INC
Entity Type:Organization
Organization Name:BOWLEM GROUP INC
Other - Org Name:BOWLEM HEALTHCARE SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:OLUWATOYIN
Authorized Official - Middle Name:
Authorized Official - Last Name:OWOOEYE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-646-8396
Mailing Address - Street 1:3814 ASQUITH CT
Mailing Address - Street 2:
Mailing Address - City:SPRINGDALE
Mailing Address - State:MD
Mailing Address - Zip Code:20774-5453
Mailing Address - Country:US
Mailing Address - Phone:301-358-0381
Mailing Address - Fax:301-772-2070
Practice Address - Street 1:1005 GREENMOUNT AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21202-4219
Practice Address - Country:US
Practice Address - Phone:410-646-8396
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-26
Last Update Date:2022-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR 2382251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD4577027-00Medicaid
MD4577035-00Medicaid