Provider Demographics
NPI:1962479295
Name:MOFRANKAL HEALTHCARE SERVICES
Entity Type:Organization
Organization Name:MOFRANKAL HEALTHCARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:REIM
Authorized Official - Middle Name:ADEDAYO
Authorized Official - Last Name:BODUNRIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-945-7470
Mailing Address - Street 1:2300 GARRISON BLVD
Mailing Address - Street 2:SUITE# 106
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21216-2308
Mailing Address - Country:US
Mailing Address - Phone:410-945-7470
Mailing Address - Fax:410-945-7459
Practice Address - Street 1:6969 RICHMOND HWY
Practice Address - Street 2:SUITE# 101
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22306-1839
Practice Address - Country:US
Practice Address - Phone:703-768-7351
Practice Address - Fax:703-768-7832
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAHCO278251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health