Provider Demographics
NPI:1831483692
Name:SAINT THERESA NURSELINK DURABLE MEDICAL EQUIPMENT SERVICES
Entity Type:Organization
Organization Name:SAINT THERESA NURSELINK DURABLE MEDICAL EQUIPMENT SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:OLUWATOYIN
Authorized Official - Middle Name:ABOSEDE
Authorized Official - Last Name:ADEYINKA
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:301-807-0277
Mailing Address - Street 1:7207 HANOVER PKWY STE C&D
Mailing Address - Street 2:
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770-2015
Mailing Address - Country:US
Mailing Address - Phone:301-459-0199
Mailing Address - Fax:301-459-3039
Practice Address - Street 1:7207 HANOVER PKWY STE C&D
Practice Address - Street 2:
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770-2015
Practice Address - Country:US
Practice Address - Phone:301-459-0199
Practice Address - Fax:301-459-3039
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SAINT THERESA NURSELINK INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-06-08
Last Update Date:2020-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR2968332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD4203542 00Medicaid
MD4200471 00Medicaid
MD9094016 00Medicaid
MD9094008 00Medicaid