Provider Demographics
NPI:1538778063
Name:BADMUS INSURANCE AGENCY
Entity type:Organization
Organization Name:BADMUS INSURANCE AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE PROGRAM DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:OLUWAPELUMI
Authorized Official - Middle Name:
Authorized Official - Last Name:OLUKOTUN
Authorized Official - Suffix:
Authorized Official - Credentials:BSN, MSHA, APRN, CCM
Authorized Official - Phone:571-400-8461
Mailing Address - Street 1:46 SOLAR CIR APT A
Mailing Address - Street 2:
Mailing Address - City:PARKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21234-6831
Mailing Address - Country:US
Mailing Address - Phone:571-400-8461
Mailing Address - Fax:
Practice Address - Street 1:46 SOLAR CIR APT A
Practice Address - Street 2:
Practice Address - City:PARKVILLE
Practice Address - State:MD
Practice Address - Zip Code:21234-6831
Practice Address - Country:US
Practice Address - Phone:443-948-2126
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HERO'S SHELTER INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-07-30
Last Update Date:2020-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No251E00000XAgenciesHome Health
No251X00000XAgenciesSupports Brokerage
No253J00000XAgenciesFoster Care Agency
No253Z00000XAgenciesIn Home Supportive Care