Provider Demographics
NPI:1528378528
Name:HIGHLY BLESSED HEALTHCARE SERVICES
Entity Type:Organization
Organization Name:HIGHLY BLESSED HEALTHCARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:DR
Authorized Official - First Name:AKINJIDE
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:AGBODO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-988-2626
Mailing Address - Street 1:9251 LOTTSFORD RD APT 3D
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-3769
Mailing Address - Country:US
Mailing Address - Phone:240-988-2626
Mailing Address - Fax:301-350-3429
Practice Address - Street 1:9251 LOTTSFORD RD APT 3D
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:MD
Practice Address - Zip Code:20774-3769
Practice Address - Country:US
Practice Address - Phone:240-988-2626
Practice Address - Fax:301-350-3429
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-09
Last Update Date:2010-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR2942P251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health