Provider Demographics
NPI:1033932157
Name:SACRED HEART INC
Entity type:Organization
Organization Name:SACRED HEART INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ADELEKE
Authorized Official - Middle Name:
Authorized Official - Last Name:OTUNUGA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-256-4642
Mailing Address - Street 1:7313 BRECKENRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-6935
Mailing Address - Country:US
Mailing Address - Phone:301-256-4642
Mailing Address - Fax:301-617-2751
Practice Address - Street 1:214 E MAIN ST
Practice Address - Street 2:
Practice Address - City:ELKTON
Practice Address - State:MD
Practice Address - Zip Code:21921-5797
Practice Address - Country:US
Practice Address - Phone:301-617-2750
Practice Address - Fax:301-617-2751
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-06
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care