Provider Demographics
NPI:1508575564
Name:DELORUS ENTERPRISES LLC
Entity Type:Organization
Organization Name:DELORUS ENTERPRISES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPLE INVESTIGATOR
Authorized Official - Prefix:
Authorized Official - First Name:STEPHINE
Authorized Official - Middle Name:
Authorized Official - Last Name:RANSOM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-531-5790
Mailing Address - Street 1:PO BOX 54152
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20032-0352
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4274 COLUMBIA PARK RD
Practice Address - Street 2:
Practice Address - City:POMFRET
Practice Address - State:MD
Practice Address - Zip Code:20675-3237
Practice Address - Country:US
Practice Address - Phone:202-531-5790
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-18
Last Update Date:2022-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory