Provider Demographics
NPI:1831731363
Name:DETOS SERVICES LLC
Entity type:Organization
Organization Name:DETOS SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MODEBOLA
Authorized Official - Middle Name:OLASUNKANMI
Authorized Official - Last Name:SANNI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-491-2741
Mailing Address - Street 1:7609 FONTAINEBLEAU DRIVE
Mailing Address - Street 2:#2213
Mailing Address - City:NEW CARROLLTON
Mailing Address - State:MD
Mailing Address - Zip Code:20784
Mailing Address - Country:US
Mailing Address - Phone:204-491-2741
Mailing Address - Fax:301-577-1174
Practice Address - Street 1:7609 FONTAINEBLEAU DRIVE
Practice Address - Street 2:#2213
Practice Address - City:NEW CARROLLTON
Practice Address - State:MD
Practice Address - Zip Code:20784
Practice Address - Country:US
Practice Address - Phone:204-491-2741
Practice Address - Fax:301-577-1174
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-16
Last Update Date:2019-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance