MEDICARE: BEULAH NURSING SERVICES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WH0200X	Home Health Registered Nurse

General Provider Information

NPI Number	:	1346892742
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BEULAH NURSING SERVICES LLC

Provider Business Mailing Address
First Line	:	10006 GOLD COAST CT
Second Line	:
City	:	UPPER MARLBORO
State	:	MD
Zip	:	20774-6087
Country	:	US
Telephone Number	:	301-395-7874
Fax Number	:

Provider Business Practice Location Address
First Line	:	1401 MERCANTILE LN STE 421
Second Line	:
City	:	UPPER MARLBORO
State	:	MD
Zip	:	20774-4321
Country	:	US
Telephone Number	:	301-395-7874
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	ADEBISI SHOWUNMI
Credential	:
Telephone Number	:	240-395-7874

Provider Enumeration Date	:	07/15/2019
Last Update Date	:	02/23/2026

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