Provider Demographics
NPI:1770397366
Name:LIVES SAVERS LLC
Entity type:Organization
Organization Name:LIVES SAVERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:OLUWAKEMI
Authorized Official - Middle Name:OLUBUNMI
Authorized Official - Last Name:OSIDELE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-575-9940
Mailing Address - Street 1:4235 SOUTHERN AVE
Mailing Address - Street 2:
Mailing Address - City:CAPITOL HEIGHTS
Mailing Address - State:MD
Mailing Address - Zip Code:20743-5767
Mailing Address - Country:US
Mailing Address - Phone:240-618-3104
Mailing Address - Fax:
Practice Address - Street 1:4235 SOUTHERN AVE
Practice Address - Street 2:
Practice Address - City:CAPITOL HEIGHTS
Practice Address - State:MD
Practice Address - Zip Code:20743-5767
Practice Address - Country:US
Practice Address - Phone:240-618-3104
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LIVES SAVERS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-02-04
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care