Provider Demographics
NPI:1255774584
Name:ADOM INCORPORATED
Entity type:Organization
Organization Name:ADOM INCORPORATED
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:ADWOA
Authorized Official - Middle Name:AMOAKOA
Authorized Official - Last Name:GYEBI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-608-8133
Mailing Address - Street 1:11331 MARYLAND AVE
Mailing Address - Street 2:
Mailing Address - City:BELTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20705-1626
Mailing Address - Country:US
Mailing Address - Phone:240-608-8133
Mailing Address - Fax:866-861-5505
Practice Address - Street 1:11331 MARYLAND AVE
Practice Address - Street 2:
Practice Address - City:BELTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20705-1626
Practice Address - Country:US
Practice Address - Phone:240-608-8133
Practice Address - Fax:866-861-5505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-17
Last Update Date:2019-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR2811251E00000X
251E00000X, 333300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333300000XSuppliersEmergency Response System Companies
No251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDR2811OtherRSA LICENSE
MD1255774584OtherNPI